To investigate the relationship between mild cognitive impairment (MCI) and white matter integrity, cerebral blood flow perfusion in patients with cerebral small vessel disease (CSVD). Methods: A total of 52 CSVD patients with MCI were recruited and assigned to the MCI group, and 40 healthy volunteers were selected as the control group. Cognitive function was evaluated by the Montreal Cognitive Assessment Scale (MoCA); cerebral blood flow (CBF) was measured by Arterial Spin Labeling (ASL) of MR perfusion imaging technique; fractional anisotropy (FA) values and the apparent diffusion coefficient (ADC) were measured by diffusion tensor imaging (DTI). Results were analyzed to evaluate the relationship between severity of cognitive impairment and cerebral blood flow perfusion. Results: The total MoCA scale scores and visual space/execution, naming, attention/calculation, language, abstract thinking, and delayed memory scores in MCI group were significantly lower than those in control group (P<0.05). Compared with the control group, the MCI group showed decreased FA values and CBF in the bilateral centrum semiovale, bilateral frontal lobe, and apical frontal lobe (P<0.05) and increased ADC in the bilateral frontal lobe and apical frontal lobe (P<0.05). FA values in the right centrum semiovale, bilateral frontal lobe, and apical frontal lobe were positively correlated with CBF (P<0.05), and the ADC in the bilateral frontal lobe and apical frontal lobe were negatively correlated with CBF (P<0.05). FA values in the right centrum semiovale and bilateral frontal lobe were positively correlated with the MoCA score (P<0.05), and the ADC in the bilateral frontal lobe was negatively correlated with the MoCA score (P<0.05). CBF in the bilateral frontal lobe and apical frontal lobe was positively correlated with the MoCA score (P<0.05). Conclusion: In CSVD patients, the integrity of white matter is an important imaging marker of MCI and shows a relationship to cerebral perfusion.