Elderly cerebral white matter lesions are mainly treated by drugs such as anti-platelet aggregation, plaque stabilization, improving circulation and promoting brain cell metabolism. Cerebral white matter lesions can be caused by immunity, infection, ischemia, poisoning, genetics and other factors, and the most common cause of cerebral white matter lesions in the elderly is cerebral ischemia. Elderly patients with white matter lesions are mostly caused by hypertension, diabetes, hyperlipidemia and other factors leading to atherosclerosis, which causes blood supply disorders in the brain and chronic ischemia and hypoxia, leading to white matter lesions. Treatment can be oral aspirin, atorvastatin and other anti-platelet aggregation, plaque stabilization drugs; ginkgo biloba, butylphthalide and other drugs to improve circulation; cytarabine, piracetam and other drugs to promote brain cell metabolism. It is also necessary to control hypertension, diabetes mellitus, hyperlipidemia and other underlying diseases, light diet, quit smoking and alcohol. Elderly patients with leukoencephalopathy are advised to consult a professional physician for early intervention and treatment, and not to blindly self-medicate to avoid further progression of the disease.