Post-stroke cognitive impairment (PSCI) occupies a prominent position among cognitive impairment associated with vascular brain pathology. The purpose – to assess cognitive functions in patients with the history of ischemic stroke, depending on the metabolic syndrome (MS) presence and to determine the peculiarities of cognitive functions dynamics in the early recovery period after ischemic stroke in the anterior circulation area in patients with and without metabolic syndrome depending on ischemic lesion localization. Materials and methods. There were 122 patients in the early recovery period after ischemic stroke enrolled into the study. Depending on the MS presence, patients with the history of ischemic stroke were divided into 2 groups: with MS (n = 72) and without MS (n = 50). All the patients were divided into 3 age subgroups: 45 – 59 years – middle age, 60 – 74 years – elderly, 75 – 89 years - senile age. All patients had general clinical, neuropsychological examination, laboratory tests; MRI of the brain. Results. There was no significant difference among patients of the main clinical groups on the frequency of pre-mild and mild cognitive impairment; however the incidence of post-stroke dementia was significantly higher among patients with MS comparing with those without MS. There was significant augmentation of PSCI severity with age in patients with MS and without it. According to the results of neuropsychological tests, the best cognitive functions recovery in 6 months after the stroke (in the early recovery period) was observed in patients without MS, especially in the cases of left hemisphere ischemic lesions. Conclusions. Patients with MS had significantly more pronounced PSCI than patients without MS. The increase in age had a negative effect on the PSCI severity both in patients with and without metabolic syndrome. The presence of MS worsened the process of cognitive functions restoration in patients with PSCI.