Objective: To systematically evaluate the impact of virtual reality (VR) technology on cognitive function in stroke patients. Methods: A computer-based search was conducted across multiple domestic and international databases for randomized controlled trials (RCTs) investigating VR interventions in patients with post-stroke cognitive impairment. The search period spanned from the inception of the databases to January 7, 2025. The Cochrane Collaboration's Risk of Bias tool and the Physiotherapy Evidence Database (PEDro) scale were employed to assess the quality of the included studies. Data analysis was performed using RevMan 5.4.1 software. Results: A total of 14 studies, involving 723 patients, were ultimately included. All included studies were of high quality, with PEDro scale scores ranging from 6 to 10. Meta-analysis results indicated that VR technology significantly improved the Montreal Cognitive Assessment (MoCA) score [MD=2.53, 95% CI (0.82, 4.24), P=0.004], the Mini-Mental State Examination (MMSE) score [MD=1.68, 95% CI (1.12, 2.24), P<0.00001], the P300 latency [MD=－25.48, 95% CI (－38.99, －11.96), P=0.0002], the P300 amplitude [MD=0.72, 95% CI (0.14, 1.30), P=0.02], and the Barthel Index or Modified Barthel Index (BI or MBI) score [MD=5.14, 95% CI (3.25, 7.03), P<0.00001] in stroke patients with cognitive impairment. However, no significant effects were observed on the Trail Making Test Part A (TMT-A) score [MD=－12.47, 95% CI (－27.16, 2.23), P=0.10] or the TMT-B score [MD=－44.35, 95% CI (－117.45, 28.74), P=0.23]. Conclusion: VR technology can improve cognitive function and activities of daily living (ADL) abilities in stroke patients.