Objective To investigate the incidence and risk factors of cognitive impairment in stroke patients complicated with diabetes, so as to provide a reference for clinical nursing. Methods A total of 226 acute stroke patients complicated with diabetes from 3 hospitals in Qinghai Province were selected, then their cognitive function was investigated by utilizing the Montreal Cognitive Assessment （MoCA） scale, and their demographic data, vascular risk factors, diet, and leisure activities were surveyed to analyze the risk factors of cognitive function. Results The participants′ incidence of cognitive impairment was 69.91%.Logistic regression analysis showed that, female sex increased the risk of cognitive impairment （OR=2.845,P＜0.05）, while eating fruits frequently, participating in leisure activities, and ADL were protective factors of cognitive impairment （OR=0.674,0.932,0.979, all P＜0.05）. Conclusion The incidence of cognitive impairment in stroke patients complicated with diabetes is high in Qinghai area.It is recommended to diet reasonably and increase the intake of fruits, combine physical exercise with intellectual activities, and strengthen the defense mechanism, so as to delay their cognitive function decline.