OBJECTIVE: Cerebral microbleeds, part of the spectrum of cerebral small vessel disease (CSVD), are possibly related to cognitive dysfunctioning. The goal of this study was to investigate the relationship between cerebral microbleeds and cognitive performance, adjusted for white matter laesions and lacunar infarcts. DESIGN: Prospective cohort study. METHODS: In 500 elderly without dementia suffering from CSVD, the presence, number and locations of microbleeds were rated on a gradient-echo T2*-weighted MRI-scans. We assessed the cognitive performance with various tests. In the statistical analyses, we adjusted for age, sex, educational level, depressive symptoms, total brain volume, white matter laesion volume, and numbers of lacunar and territorial infarcts. RESULTS: The mean age was 65.6 years (SD: 8.8) and 57% of the patients was male. A total of 52 patients (10.4%) had microbleeds. The patients with microbleeds were significantly older, had a higher white matter laesion volume and more lacunar infarcts (all p < 0.001). The presence and number of microbleeds were related to poorer general cognitive functioning, lower psychomotor speed and decreased attention. Microbleeds in the frontal, temporal and deep-brain regions correlated strongest with cognitive dysfunctioning. CONCLUSION: The presence of frontally-, temporally- and deeply-located microbleeds was related to poorer cognitive performance in elderly without dementia, independent of other CSVD-related laesions. The assessment of microbleeds should be included in the evaluation of vascular cognitive dysfunction.