Objective To explore the effects of modified visual scanning exercises combined with task-specific training on cognitive function and balance in stroke patients with hemiplegia, and to identify a safe and effective training approach. Methods From August 2024 to April 2025, 96 stroke patients with hemiplegia and cognitive impairment were enrolled and randomly divided into three groups using a random number table:a control group, an experimental group 1, and an experimental group 2, with 32 patients in each group.The control group received conventional rehabilitation therapy and nursing care.The experimental group 1 additionally received modified visual scanning exercises, and the experimental group 2 received both modified visual scanning exercises and task-specific training.The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the Tinetti Perfor-mance-Oriented Mobility Assessment （POMA） were utilized to collect data at three time points:before the intervention, at 2 and 4 weeks after the start of the intervention. Results Thirty-one patients in each group completed the study.At 4 weeks after the start of the intervention, the experimental group 2 demonstrated significantly higher scores for cognitive function and gait and balance performance compared to the control group and the experimental group 1 （all P＜0.05）. Conclusion Modified visual scanning exercises combined with task-specific training can effectively improve cognitive function and balance in stroke patients with hemiplegia, thereby promoting patient recovery.