Mild cognitive impairment (MCI) represents an intermediate stage between normal cognitive changes associated with aging and dementia. Individuals with MCI have been identified as having a faster rate of progression to dementias. Risk factors for progression include greater cognitive deficits at baseline, ApoE4 carrier status, brain volume changes, cerebrospinal fluid (CSF) changes, and the presence of behavioral and psychological symptoms. Refinements in the diagnostic criteria for MCI and the identification of biomarkers to predict the progression to dementias have resulted in the appropriate diagnosis of this condition being made and the development of possible prevention and treatment strategies. Available data indicate that cognitive and physical training appears to slow the progression of the disease process. Studies of pharmacotherapeutic agents do not indicate benefit for cholinesterase inhibitors, the anti-inflammatory drug rofecoxib, or antioxidants in slowing the progression of MCI to dementias.