Objective: To analyze the effect of pulsatile perfusion and non-pulsatile perfusion on early postoperative cognitive function in patients undergoing cardiac surgery. Methods: A total of 62 patients undergoing cardiac surgery at our hospital from June 2020 to December 2021 were selected as the study subjects, and they were divided into a non-pulsatile perfusion (NPP) group and a pulsatile perfusion (PP) group by random number table method, with 31 patients in each group. NPP group received non-pulsatile perfusion maintenance with cardiopulmonary bypass, and the experimental group received pulsatile perfusion maintenance. Mini-Mental State Examination (MMSE) scores were performed 1 day before surgery (T0), 3 days after surgery (T1), and 7 days after surgery (T2), respectively. Z-score method was used to determine the post-operative cognitive dysfunction (POCD) of patients and calculate the incidence of POCD between the 2 groups. In addition, baseline data, operative data and postoperative events of patients in the 2 groups were recorded and compared. Results: The urine volume in cardiopulmonary bypass and ICU of the experimental group were higher than those of NPP group, while the lactic acid value, postoperative ventilator use time and ICU stay time were lower than those of NPP group, and the differences were statistically significant (P<0.05). In terms of postoperative cognitive function, during the period of T1 and T2, intra-group comparisons showed statistically significant differences in the scores of each test item between the 2 groups (P<0.05). During T1, PP group had significantly higher lexical association and tracking time than NPP group (P<0.05). During T2, there was no significant difference between PP group and NPP group in all test items (P>0.05). There was no significant difference in POCD level between the 2 groups in the early postoperative period (P>0.05). Conclusion: Pulsatile perfusion cardiopulmonary bypass cannot improve the early cognitive function of patients after cardiac surgery, but it has potential organ protection effect and can shorten the ICU stay time, which is worthy of clinical application.