The editors of this book and its contributors are to be thanked and congratulated for lighting a beacon that shines brightly into the murky corners of conceptual and diagnostic knowledge and understanding of vascular cognitive impairment. All the big hitters in the field have contributed to what really is the best available single text on the subject. Genetics, pathology, phenomenology, epidemiology, economics, treatment, and prevention are all covered in authoritative and bang up-to-date detail. But the first and last chapters, both written by the editors, should be compulsory reading for all of us. It was only after I had read the first chapter—a critical appraisal of current diagnostic criteria for vascular dementia—that I truly began to understand just how limited these are and how stacked they are against making a diagnosis of anything other than Alzheimer’s disease. This of course might not matter were it not for the evidence reviewed by contributors to the book that vascular dementia is a real and prevalent diagnosis and can be modified by treatment. In the final chapter, the editors outline a diagnostic framework from which they hope definite operational criteria for what they call vascular cognitive impairment will be developed. Emphasis on subcortical and frontal deficits rather than memory impairment and a challenge to the traditional requirements for remorseless progression, focal signs, and imaging evidence of infarction make up the meat of their persuasive argument. This is one of those rare books that I would have gone out and bought if I hadn’t received my reviewer’s free copy. There is no stronger recommendation.