This study aimed to investigate the differences in cognitive function of patients with acromegaly and non-functioning pituitary adenoma and healthy population, , as well as to determine whether the patients exhibit cognitive impairment and identify any relevant influencing factors. Methods: The clinical data of 22 consecutive patients with acromegaly, each with pathologically confirmed growth hormone-secreting pituitary adenoma treated surgically at the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2021 to August 2022 were retrospectively analyzed. Meanwhile, 22 age- and gender-matched individuals with non-functioning pituitary adenomas and healthy individuals were selected as controls for the retrospective analysis. All participants underwent regular follow-up involving assessment of cognitive function. Results: Six (27.3%) patients with acromegaly exhibited mild cognitive impairment, and the incidence was higher than that in the healthy population (P<0.05). Cognitive function outcome values were lower in the patients with acromegaly than in the healthy population, especially in terms of memory (P<0.05). At three months postoperatively, there were no significant differences in cognitive function changes in patients with acromegaly. Tumor type and gender were observed to influence delayed recall scores in patients with acromegaly and those with non-functioning pituitary adenoma (P<0.05). Conclusion: In summary, the incidence of mild cognitive dysfunction was higher in patients with acromegaly than in the healthy population. Additionally, there was no significant short-term effect of surgical treatment on cognitive function in patients with acromegaly