Context: Vascular cognitive impairment (VCI) or vascular dementia is widely considered to be the second-most-common cause of dementia after Alzheimer's disease, accounting for 20% of cases. Little is known about the effectiveness of breath qigong for seniors suffering from VCI or dementia.Objectives: For seniors with VCI, the study aimed to compare the benefits of qigong practice, cognitive training, and qigong practice + cognitive training in improving cognitive function, memory, executive function, and daily problem-solving ability. Design: The study was a randomized, controlled pilot study that used a prospective design with repeated measures. Setting: The study took place at the Tianjin Medical University General Hospital (Tianjin, China). Participants: Participants were 93 patients with VCI at a clinic at the hospital. Intervention: The participants were randomly assigned to 1 of 3 groups: (1) qigong practice, an intervention group; (2) cognitive training, a positive control group; or (3) a combination of qigong practice and cognitive training, an intervention group. Participants received the treatments for 3 mo. Outcome Measures: All outcome measures were undertaken at baseline and postintervention. The measures included (1) the Montreal cognitive assessment, (2) the Loewenstein occupational therapy cognitive assessment, and (3) the Barthel activities of daily living index. Results: All 3 groups showed significant improvements in general cognitive function, memory, executive function, and daily problem-solving ability (P < .05). Conclusion: Qigong practice is an easy and convenient exercise performed at no cost and has the potential to improve the cognitive functions of older adults with mild VCI.