Abstract: With the aging of the population, the incidence of Alzheimer’s disease (AD) is increasing, which has become a global public health problem. Studies have shown that Aβ deposition, tau hyperphosphorylation, gene mutation, chronic inflammation and metabolic disorders are important mechanisms leading to the pathogenesis of AD. Recent studies have found that cerebral microangiopathy plays an important role in the occurrence and development of AD. In this paper, the pathological mechanism of microvascular lesions in AD was mainly discussed to provide a basis for early prevention and comprehensive treatment of AD.