Vascular mild cognitive impairment (vascular MCI) describes an abnormal condition which is caused by vascular diseases and in which the patient presents with cognitive deficits not severe enough to fit the criteria for dementia (i.e., basic functional autonomy is not lost). As in neurodegenerative MCI, the clinical, neuroimaging, and natural history features of vascular MCI are currently under definition. It is particularly important to identify cognitive impairment of vascular origin during the early stages, as its progression may be slowed or halted by intervening with aggressive treatment of vascular risk factors and diseases. Longitudinal studies on the natural history of vascular MCI, with investigation of the factors responsible for the transition to dementia, are worthy of being planned and carried out.