AIM: to review information sources on this issue in order to provide up-to-date knowledge on the pathogenesis of this condition Materials and Methods: An analysis of data from literary sources and medical articles in PubMed was carried out in order to clarify the the role of Lipoprotein (a) in cerebral atherosclerosis. Conclusions: Cardiovascular diseases remain the leading cause of disability and mortality globally. While dyslipidemia is a well-established risk factor for coronary atherosclerosis and myocardial infarction, its role in the development of intracranial atherosclerosis is less well characterized. Current evidence suggests that plasma measurement of lipoprotein(a) [Lp(a)] using validated assays is sufficient for cardiovascular risk stratification, obviating the need for genetic testing of Lp(a). Advanced diagnostic methods have demonstrated that elevated Lp(a) levels are associated with increased vascular wall inflammation, reinforcing its causal role in atherogenesis. Intracranial atherosclerosis, a major cause of ischemic stroke, is linked to a heightened risk of recurrent cerebrovascular events and the progression of vascular cognitive impairment. Although Lp(a) is a recognized risk factor for stroke, its predictive value appears to be lower than that for coronary heart disease or composite cardiovascular outcomes. Therefore, the clinical implications of elevated Lp(a) levels in relation to carotid and intracranial atherosclerosis merit further investigation, particularly in the context of stroke prevention and vascular dementia. KEY WORDS: cerebral atherosclerosis, Lipoprotein (a), cardiovascular risk