The prevalence of cognitive impairment is particularly higher in patients with end-stage renal disease (ESRD) than in healthy people, resulting in less treatment compliance, poorer life quality and lower survival rate in these patients. This may closely relate to the higher vascular risks, dialysis-related physiological factors and psychosocial factors. This article introduces the present situation of cognitive impairment in ESRD patient, the related risk factors causing cognitive impairment, assessment and management measures, hoping to stimulate further studies, clinical diagnosis and treatment to this problem.