Background Recent researches demonstrate that damage of executive function is an early manifestation of vascular cognitive disorder. Objective To investigate the executive functions of patients with transient ischemic attack (TIA). Design Case control. Setting Department of Neurology, the First Affiliated Hospital of Xinxiang Medical College. Participants A total of 83 TIA patients (46 males and 37 females, aged 32–74 years) were selected from Department of Neurology, the First Affiliated Hospital of Xinxiang Medical College from July 2005 to December 2006. The diagnosis of TIA was established by the criteria of cerebrovascular diseases made by the Fourth National Cerebrovascular Disease Meeting. In these cases, forty-five patients (54%) were involved in internal carotid artery, and thirty-eight patients (46%) were involved in vertebral basilar system. Fifty healthy adults (Control group: 28 males and 22 females, aged 32–74 years) were chosen from retiree in community and family of patients. All of them were right-handedness, without cerebrovascular disease, cerebral trauma, inborn oligophrenia, and hearing and visual disorders; also they had no anxiety and depression nearly one week. In addition, all the subjects cooperated with examination. Methods After TIA diagnosis, all patients received neuropsychological examination, including attention and inhibition, working memory, flexibility, planning and diversion, based on Stroop tests (C and CW) and the Wisconsin card sorting tests (WCST). ▪ WCST test: The edition revised by Nelson was used. We would take the times of sorting, incorrect response, persistent incorrect response, and randomly incorrect response as the index of evaluation. ▪ Stroop tests: The edition revised by Trenarry was used and this test had two types: form color and form color-word. Their incorrect response and response time were recorded for data analysis in the end. Main outcome measures Results of WCST test and Stroop tests. Results A total of 83 TIA patients and 50 healthy subjects were involved in the final analysis. Items of Stroop tests, including response time of Stroop-C test, incorrect response of Stroop-C test, response time of Stroop-CW test and incorrect response of Stroop-CW test, and items of WCST, including incorrect response, persistent incorrect response and random incorrect response, between internal carotid artery system and vertebral basilar artery system were (93.87±24.39) s, 3.16±3.97, (228.46±68.13) s, 12.91±10.56, 55.42±20.38, 26.58±10.41, 28.62±11.22; (96.76±24.75) s, 3.89±4.77, (223.46±72.54) s, 18.71±13.80, 52.47±22.25, 28.82±16.20, 23.39±9.72, respectively; this was higher than those in the control group [(52.10±12.18) s, 1.68±1.97, (134.86±34.15) s, 4.22±4.21, 32.46±17.97, 14.42±8.47, 18.24±10.24, P < 0.05–0.01]. Times of sorting of WCST between internal carotid artery system and vertebral basilar artery system were obviously lower than those in the control group (8.27±2.73, 8.66±2.77, 11.22±2.41, P < 0.01). However, there were no significant differences between internal carotid artery system and vertebral basilar artery system ( P > 0.05). Conclusion Patients with TIA have executive dysfunctions, and the dysfunctions have no difference between internal carotid artery system and vertebral basilar artery system.