It has been reported that 20-65% of cerebral infarction patients suffers from depression. On the other hand, elderly-onset depression has more cerebro-vascular changes such as deep white matter lesion and periventricular hyperintensity on MRI than young-onset depression. These findings together leads new disease category 'vascular depression' (VD), meaning depression primarily caused by cerebral infarction. VD patients show less family history and symptomatic changes within a day than those with non-vascular depression. Though anti-depressants are effective on VD, they have higher incidence of side effect on VD than on non-vascular depression. Benzodiazepines and cerebral circulation and metabolism enhancers are also used in VD therapy. The prognosis of VD is worse than that of non-VD or cerebral infarction without depression.