Radiotherapy (RT) remains a kind of front-line treatment for the control of tumor growth, especially for brain cancer. It is well known that cognitive impairment is mainly caused by cerebral RT, but the mechanisms underlying radiation-induced cognitive impairment remain unclear. There are different views on the cognitive dysfunction caused by RT in different studies. The recently research evidences about this topic are reviewed in present work. We found a few of factors including brain injury directly caused by radiation, cerebral tissue ischemia and necrosis caused by cerebrovascular injury, oxidative stress and brain injury mediated by inflammation, etc. which play a crucial role in the cognitive dysfunction caused by radiotherapy. These have all been widely recognized, and recently evidences have also shown that potential therapeutic interventions can effectively prevent cognitive impairment.