Objective To investigate the incidence of perioperative neurocognitive disorders (PND) in patients after lung transplantation, and explore PND's risk factors and its model's predictive efficiency. Methods Patients who underwent lung transplantation in Wuxi People's Hospital from June 2019 to May 2020 were enrolled. They were assessed by the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) Scales one day before surgery and Day 7, one month and three months after operation. According to the presence of PND, they were divided into two groups: a non‑PND group and a PND group. The following information was collected: general information; perioperative conditions including American Society of Anesthesiologists (ASA) classification, ventricular pulmonary artery pressure, cold lung ischemia time, the use of extracorporeal membrane oxygenator (ECMO), pulmonary artery occlusion time, anesthesia time, operation time, intraoperative blood loss, intraoperative urine volume, total intraoperative fluid infusion, total intraoperative blood transfusion, norepinephrine dosage and intraoperative hemoglobin (Hb) reduction rate; ECMO bypass time after entering intensive care unit (ICU), extubation time, ICU retention time, and lactic acid value three days after surgery. Logistic regression model was used to analyze the independent risk factors of neurocognitive disorders in patients on Day 7 after lung transplantation. A receiver operating characteristic (ROC) curve was plotted to verify the predictive efficiency of the model for PND. Results A total of 101 patients were included, and the incidence of PND was 32.7% (33/101) on Day 7 after surgery, which then decreased to 14.9% (15/101) one month after surgery, and 8.9% (9/101) three months after surgery. According to the univariate analysis, increases were found in the PND group as to the cold ischemia time of the donor lung, the use of ECMO, postoperative ECMO bypass time, the length of ICU stay on Day 7 after surgery and lactic acid value on Day 2 after surgery, compared with the non‑PND group. Furthermore, the PND group presented increased postoperative ECMO bypass time one month after operation as well as increased length of ICU stay three months after operation, compared with the non‑PND group. According to multivariate logistic regression analysis, the cold ischemia time of the donor lung and the length of ICU stay were the independent risk factors for postoperative PND on Day 7 after lung transplantation. The area under curve (AUC) was 0.709 (95%CI 0.603‒0.815, P<0.01), with a sensitivity of 45.5% and a specificity of 88.2% for predicting PND. Conclusions The incidences of PND are 32.7%, 14.9% and 8.9% on Day 7, one month and three months after lung transplantation, respectively. The cold ischemia time of the donor lung and the length of ICU stay are the early risk factors for PND on Day 7 after lung transplantation.