Background Postoperative cognitive dysfunction (POCD) which is a decline in cognitive function after surgery and anesthesia occurs predominantly in elder people. It is likely to impair quality of life and constitutes a large burden on society. Objective The purpose of this review is to discuss recent development in the pathogenesis of POCD, and to minimize the incidence of POCD. Content Here we review the definition and discuss pathogenesis and risk factors of this condition. Trend Although there is general agreement that POCD is likely to be multifactorial, the main pathogenesis remains unclear. The increasingly aged population has stimulated research on this condition, which is helpful to identify underlying pathogenesis and to take comprehensive measures to prevent and treat POCD.