To date, there is a controversy on effects of cognitive intervention to maintain or improve hippocampal function for older adults with mild cognitive impairment (MCI). The main objective of this study was to exam effects of virtual reality-based spatial cognitive training (VR-SCT) using VR on hippocampal function of older adults with MCI. Fifty-six older adults with MCI were randomly allocated to the experimental group (EG) that received the VR-SCT or the waitlist control group (CG) for a total of 24 sessions. To investigate effects of the VR-SCT on spatial cognition and episodic memory, the Weschsler Adult Intelligence Scale-Revised Block Design Test (WAIS-BDT) and the Seoul Verbal Learning Test (SVLT) were used. During the sessions, the training performances gradually increased (p < .001). After the intervention, the EG showed significant greater improvements in the WAIS-BDT (p < .001, η2 = .667) and recall of the SVLT (p < .05, η2 =.094) compared to the CG but in recognition of the SVLT (p > .05, η2 =.001). These results suggest that the VR-SCT might be clinically beneficial to enhance spatial cognition and episodic memory of older adults with MCI.