Cognitive impairment is common in heart failure patients which involve different cognitive domains, including memory, attention, executive function, language and psychomotor speed, language and visual space. It affects the patient’s self-care ability, the degree of coordination of the treatment plan, and the decision-making ability when the symptoms deteriorate. Therefore, the early recognition and timely intervention of cognitive impairment in patients with heart failure is very necessary and has important clinical significance. However, there is a lack of understanding of cognitive impairment in patients with heart failure, and lack of consensus in screening tools and treatment measures. The mechanism of cognitive impairment related to heart failure is the result of multifactor synthesis, which is mainly related to circulatory dysfunction and changes in the brain, mainly affecting the cognitive fields such as memory, attention, executive function, etc. MINI-COG is the first choice of the assessment scales. The instruments used are MRI, fMRI, and transcranial Doppler. The therapeutic measures include surgery, education, medicine, physical therapy, aerobic exercise, etc. Generally, comprehensive intervention measures are used.