When one thinks of vascular risk factors to Alzheimer’s disease (VRF-AD), several things may come to mind. First, what are VRF-AD and why are they important? Second, why or what makes them a pathological risk to Alzheimer’s disease (AD)? Third, how can they be identified or diagnosed? Fourth, what interventions if any, can be used to manage VRF-AD and could they help reduce or reverse the prevalence of cognitive decline and AD? This special issue of the Journal of Alzheimer’s Disease titled “Physiopathology of Vascular Risk Factors in Alzheimer’s Disease” is dedicated to these four questions and many others which relate to their profile, pathophysiology, diagnosis, and intervention. A panel of international experts from 16 countries pooled their knowledge to provide clarity and insight into VRF-AD, one of the fastest growing fields in AD research. VRF-AD were rarely if ever mentioned in the medical literature prior to 1997. That year, several prospective epidemiological studies discovered what turned out to be a breakthrough in our limited understanding of AD. The studies reported how specific maladies that directly affected the cerebral vasculature could lead to the development of cognitive decline and AD onset. As more studies began evaluating large populations of middle age and elderly individuals with hypertension, atherosclerosis, diabetes type 2, hyperlipidemia, and heart disease, it became clear that a