Abstract: Ｏｂｊｅｃｔｉｖｅ：This retrospective cohort study was intended to evaluate the clinical and imaging characteristics and prognosis of autosomal dominant polycystic kidney disease (ADPKD) with cerebrovascular complications, and to improve the awareness of those patients.Ｍｅｔｈｏｄｏｌｏｇｙ：We retrospectively analyzed the 29 ADPKD patients  complicated with intracerebral hemorrhage (ICH),subarachnoid hemorrhage (SAH) or unruptured intracranial aneurysms (UIA) who were admitted to the Intensive Care Unit (ICU) of Jinling Hospital from January 2001 to January 2020. We analyzed the clinical manifestations and imaging characteristics of ADPKD patients with cerebrovascular complications and followed up the longterm prognosis.Ｒｅｓｕｌｔｓ：Among the 29 patients,17 males and 12 females,with an average age of 485 (4125,540) years old were included in this study,including 12 cases of ICH,12 cases of SAH,and 5 cases of UIA. The 8 patients who  died during followup had a lower GCS score on admission (P=0029) and significantly higher serum creatinine and blood urea nitrogen (P<0001) compared with the other 21 patients with longterm survival.Ｃｏｎｃｌｕｓｉｏｎ：Cerebrovascular diseases are common in ADPKD which may lead to severe disability or death. Therefore,ADPKD patients need to monitor blood pressure and screen for intracranial vascular diseases.