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Small retinal and cerebral arteries share the same characteristics. Our objective was to describe the retinopathies of patients that have suffered from infarctions of these small cerebral arteries (lacunar strokes) and to examine their correlation with the cognitive status of these patients. Methods: We conducted a descriptive cross-sectional study of patients with recent lacunar strokes, confirmed by a CT scan and a fundus examination, examined in the Neurology Department of Antananarivo in Madagascar between July 2018 and December 2019. We measured stroke severity with the National Institute of Health Stroke Scale (NIHSS) and cognitive impairment with the Mini-Mental Status Examination (MMSE) and the Rapid Frontal Efficiency Battery (BREF in French). Results: Lacunar strokes with a fundus examination performed represented 7.92% of all strokes in our department (51 patients). All patients were hypertensive, and 9 were diabetic. On fundus examination, hypertensive retinopathy was present in 52.94% (27/51) of cases but did not correlate with age, clinical severity (measured by NIHSS), or cognitive impairment. Diabetic retinopathy was found in 3.92% of patients (2/51), which correlated with age over 65 years and cognitive impairment (BREF Conclusion: Knowledge of the characteristics of retinopathy in patients with lacunar infarcts would allow for better detection and early management of cognitive impairment.