Vascular cognitive impairment (CI) is an urgent medical problem due to its high prevalence, progressive course, and high degree of disability. CI may be associated not only with the direct effects of stroke, but also with the presence of premorbid cognitive decline of both vascular and neurodegenerative nature. In addition to vascular risk factors, there are a number of factors leading to dementia, and the heterogeneity of the nature of CI is noted. The management of patients with CI is complicated due to the comorbidity of most of them, as well as low adherence to medical recommendations. The review is devoted to the consideration of the possibility of complex therapy, including non-drug, medical treatment methods, as well as lifestyle changes that affect modifiable risk factors for vascular dementia. Data are presented on the expediency of using a prolonged form of pentoxifylline (Vasonit) in a daily dosage of 600—1200 mg in the complex treatment of patients with CI (including those caused by chronic cerebral ischemia) in terms of efficacy and safety, as well as improving patient compliance. To illustrate, a clinical example is given based on our own experience using Vasonite.