Background: The blood vessels in the retina are available for viewing in a noninvasive way and have similar anatomical, physiological as features small vessel brain. Also the white matter lesions (WMLs) brain are most frequently associated with lacunar stroke Objective: To determine the relationship between cerebral white matter lesions and retinal microvascular alteration in lacunar stroke. Material and methods: Cross-sectional study, patients with acute stroke was evaluated. Arteriovenous crossings, focal or diffuse arteriolar narrowing, retinal hemorrhages, cotton wool spots, alteration in vascular path, microaneurysms, the presence of retinal microvascular abnormalities was assessed. The WMLs were evaluated with a ranking of 1 to 9. Lacunar Stroke was classified by the score of TOAST. Results: A total of 67 patients were evaluated, classified as lacunar stroke 23.88% (n:16), the average age was 70.06 years, 50% were men, the main risk factors hypertension 68.75%, hypercholesterolemia 50%, diabetes 31.25%. In reference to the degree of WMLs grade 4-9 was superior to no lacunar stroke with 68.75% vs. 56.86%, the presence of retinopathy was also higher in lacunar stroke with 68.75% vs. 52.94%, but we found the presence of retinopathy in patients without diabetes and hypertension. Conclusion: WMLs and altering of retinal microcirculation are more prevalence in patients with lacunar stroke. Likewise, the retinopathy may be present in these patients despite not having recognized cardiovascular risk factors.