Objective To identify the risk factors for postoperative short-term cognitive dysfunction (STCD) in the patients undergoing carotid endarterectomy. Methods A total of 158 patients with carotid artery stenosis, aged≥18 yr, without preoperative cognitive dysfunction, undergoing carotid endarterectomy from January 1, 2014 to May 30, 2017 in our hospital, were selected.Factors including age, sex, height, weight, education, presurgical complications (hypertension, type Ⅱ diabetes mellitus, myocardial infarction and brain infarction), degree of internal carotid artery stenosis, preoperative mean arterial pressure (MAP), amount of dexmedetomidine, duration of operation, time of carotid artery occlusion, MAP during occlusion period, intraoperative volume of fluid infused (crystalloid solution and colloid solution), urine volume, blood loss, significant change in electroencephalogram (EEG) and visual analogue scale scores at 24 h after surgery were collected.Mini-Mental State Examination was used to evaluate the cognitive function at 24 h after surgery.The patients were divided into STCD group and non-STCD group according to whether or not patients developed postoperative STCD.The risk factors of which P values were less than 0.05 would enter the bivariate logistic regression analysis to stratify the risk factors for postoperative STCD. Results Forty-nine patients developed postoperative STCD (31.0%). The intraoperative amount of colloid solution infused<5 ml/kg, increase in MAP<20% of the baseline value during the occlusion period, and significant change in EEG during the occlusion period were independent risk factors for postoperative STCD (P<0.05). Conclusion The intraoperative amount of colloid solution infused<5 ml/kg, increase in MAP<20% of the baseline value during the occlusion period, and significant change in EEG during the occlusion period are independent risk factors for postoperative STCD in the patients undergoing carotid endarterectomy. Key words: Cognition disorders; Risk factors; Endarterectomy, carotid