Objective: To explore the effect of endovascular stent implantation in improving hemodynamic parameters and cognitive function in patients with cerebrovascular stenosis. Methods: 121 patients with cerebrovascular stenosis admitted to our hospital from May 2023 to May 2024 were selected as the research subjects. The patients were divided into the control group (n=60) and the observation group (n=61) according to the differences in surgical methods. The control group was treated with angioplasty. The observation group was treated with endovascular stent implantation. The degree of vascular stenosis, hemodynamic parameters [peak systolic velocity (PSV), diastolic velocity (EDV)], cognitive function [Montreal Cognitive Assessment Scale (MOCA)] and the occurrence of complications were analyzed and compared between the two groups. Results: Three months and six months after the operation, the levels of PSV and EDV and the degree of vascular stenosis in both groups were significantly lower than those before the operation. Moreover, the levels of PSV and EDV and the degree of vascular stenosis in the observation group at 3 months and 6 months after the operation were significantly lower than those in the control group (P<0.05). At 3 months and 6 months after the operation, the MOCA scores of both groups were significantly higher than those before the operation, and the MOCA scores of the observation group at 3 months and 6 months after the operation were significantly higher than those of the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Endovascular stent implantation can improve the hemodynamics of patients, reduce the degree of vascular stenosis, improve the postoperative cognitive function of patients, and reduce complications.