Aim To analyse the vascular risk factors and the relation with atherosclerosis between different degree periventricular white lesions(PVL) and deep white matter lesions(DWML) in advanced age people. Methods The severity of PVL and DWML was graded and the cognitive score,vascular risk factors,lacunar infarction numbers,carotid atherosclerotic plaque score,the cerebral blood flow velocity and pulsatility index(PI)of intracranial vessels of the different grade participants were analyzed. Results Both severe PVL and DWML had significant difference in cognitive score(P<0.05),while severe PVL had significant difference in morbidity rate of hypertension and diabetes mellitus(P<0.05),and DWML had significant difference in lipidemia and lacunar infarction number(P<0.05).Severe PVL manifested both large and small vessel atherosclerosis(P<0.05),and severe DWML was only found with large vessel atherosclerosis(P<0.05). Conclusions Severe PVL and DWML both induced cognitive impairment.The small vessel atherosclerosis and hypoperfusion may play roles in the pathogenesis of PVL,and DWML may be involved in lipid factors and lacunar infarction.