Obstructive sleep apnea (OSA) has been associated with mild cognitive impairment (MCI). Cerebral small vessel disease (CSVD) is considered a neuroimaging marker for MCI. Objective: To evaluate the association between OSA, cognitive impairment and vessel disease. Methods: We prospectively recruited individuals diagnosed through polysomnography with severe OSA (S; n=21), moderate OSA (M; n=18), and healthy individuals (H; n=9). Behavioral Data included screening tests with Montreal Cognitive assessment test (MOCA), Ineco Frontal Screening Test (IFS), Language by verbal fluency, Verbal Memory by selective memory verbal test, Attention executive by paced auditory serial addition test (PASAT), selective attention by digit symbol of WAIS, and executive functions like inhibition by Stroop test and Hayling test. Lesions in white matter was established through Magnetic resonance imaging (MRI). Results: The frequency of CSVD was higher in patients with OSA ((H=22%; M=38%; S=38%). Splitting the participants according to SVD, we found significant differences in cognitive parameters such LTMs (nonSVD=29; SVD=38, p=0.05) and PASAT (nonSVD=6.7; SVD=10.6 p=0.03). Data as mean ± SEM. LTMs scores varied according to the group (H=40±6; M=38±3 and S=28±3) with significant differences H vs S (p=0.04) and M vs S (p=0.02). Remaining cognitive measurements, between those groups were not different. Conclusions: These preliminary findings suggest that mild cognitive impairment in patients with OSA is associated with CSVD