With the aggravation of population aging，the incidence of cerebral small vessel disease is getting higher and higher，which has become a hot and difficult issue in current research.Based on the theory of traditional Chinese medicine，combined with modern medical research，this paper discusses the pathogenesis of cerebral small vessel disease，puts forward that qi deficiency and blood stasis are one of the basic pathogenesis of cerebral small vessel disease，and expounds that the method of invigorating qi and activating blood circulation and removing blood stasis is the main treatment of cerebral small vessel disease in fluctuating period.Dynamic management based on the characteristics of the disease and its etiology and pathogenesis can cut off the progress of the disease in time，reduce the generation of brain lesions，and prevent damage to nerve function.Replenishing vital energy，promoting blood circulation，eliminating blood stasis simultaneously，taking consideration of specimen，provide new ideas for the treatment of cerebral small vessel disease.