Cognitive impairment after stroke is a common residual symptom and problematic. Cognitive impairment can have a significant impact on one´s ability to function independently and to return successfully to the previous level of daily activities. Although there is no accepted pharmacologic intervention for the treatment of cognitive impairment in this population, the logical neurotransmitter system to target would be the cholinergic system. The use of cholinergic agents to improve cognition has been investigated in the Alzheimer´s population. In many studies, donepezil- an acetylcholinesterase inhibitor that is highly selective for central acetylcholinesterase -has been shown to have the effectiveness and safety in the treatment of cognitive impairment that is commonly encountered in Alzheimer´s disease or traumatic brain injury population. In this report, we describe a stroke patient with cognitive impairment, who has shown significantly improved cognitive function and functional level after the treatment with donepezil.