Visual search is a crucial task in daily life, but in Alzheimer's disease (AD) it has usually been investigated using simple arrays. Here, we used scenes depicting real environments and studied the time course of attentional guidance. We analyzed eye-movement differences between mild AD patients and age-matched healthy controls during search. We examined top-down guidance, manipulating the target template (precise picture vs. word cue) and the target-scene semantic consistency (consistent vs. inconsistent), and bottom-up guidance, manipulating the perceptual salience (high vs. low) of targets and distractors. During scene scanning, AD patients had longer search times, made more fixations before the first target fixation, and showed a greater probability of distractor selection, with longer distractor fixation. AD also led to longer target fixation. In patients and controls, picture cues and highly salient targets improved all search phases, whereas consistent targets only improved search initiation (first saccade). Moreover, top-down and bottom-up guidance interacted in initiation and scanning, and this did not differ between the two groups of participants. However, AD led to a smaller picture cue benefit in shortening distractor fixation and greater bottom-up search facilitation during scanning, where a high-salience target reduced the performance gap between patients and controls. Our study shows the importance of top-down and bottom-up guidance, and their integration, in improving search in AD patients. It suggests that precise target cues and, even more, highly salient targets may act as environmental supports that enhance attentional processing and search performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).