Small Vessel Disease (SVD) is a group of pathological conditions affecting the small arteries, arterioles, capillaries, and small veins in the brain. It is one of the main causes of stroke and dementia, significantly impacting global health. This chapter delves into the epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and management strategies for SVD. Through an exploration of current research and clinical practices, we aim to provide a comprehensive understanding of this complex disease and its implications for patient care.