Cerebral small vessel disease is also one of the research priorities of our team, especially hereditary cerebral small vessel disease, which is currently undergoing its third NSF project. There are a large number of misconceptions about the treatment of this disease in China. The state of treatment of this disease in our country is similar to other poor third world, and most doctors are happy to spread knowledge that they do not know right from wrong, and the backwardness comes from the lack of critical thinking and innovation. Cerebral small vessel disease is a group of diseases in which small arteries, tiny arteries, capillaries and tiny veins are the main lesions. The main manifestations are small strokes and cognitive impairment as well as cerebral hemorrhage and microhemorrhage. Most of the causes are vascular aging, hypertension-related vascular disease, and amyloidosis. Rarely, the causes are hereditary vascular diseases, including various dominant hereditary cerebral arteriopathies, recessive cerebral arteriopathies, mitochondrial vascular disease, and Fabray disease. Fibrosis or deposition of abnormal material in the vessel wall is the common pathological change. Since their pathogenesis is different from atherosclerosis of large arteries, it is a mistake of principle to think that the treatment of large vessel disease can be copied. Treatment varies greatly from one etiology to another. The following measures are generally taken: symptomatic treatment hemiplegia, regardless of the cause, do not perform acute phase thrombolysis, patients with mostly mild symptoms, don’t treat small diseases, small vascular disease has a high risk of bleeding with a lot of microhemorrhages. Focus on rehabilitation and clopidogrel and cilostazol antithrombotic. Cognitive-emotional disorders, memantine and nimodipine are somewhat effective. Allopathic treatment Blood pressure control medications to prevent pharmacologic postural hypotension. Angiotensin-converting enzyme inhibitors such as benazepril can be given for hypertensive small arteriosclerosis as well as CARASIL. Drugs that protect smooth muscle cells and endothelial cells. Statin lipid-lowering drugs can be used, but beware of their mitochondrial toxicity and the possibility of inducing myositis. Drugs that promote vascular development need to be given Starch-like vasculopathy requires reduction of starch-like deposition in blood vessels