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Cognitive dysfunction is common in geriatric medicine and represents a risk factor for postoperative mortality. Objective: to determine the predictive factors of cognitive dysfunction in postoperative in the elderly subject in Urology surgery.Prospective study conducted in the urology department of the Rabta Hospital, including patients who underwent surgery scheduled from November 2021 to January 2022. Cognitive dysfunction was assessed by the postoperative MMSE score. One hundred and four patients were included. The incidence of patients with impaired MMSE score was 66% at one week and 68% at one month postoperatively. Intraoperative transfusion and length of stay were two independent predictors of cognitive impairment at one week postoperatively (OR=3.22; 95% CI [1.03-10.03], p=0.043 and OR=3.1, 95% CI [1.08-8.87], p=0.034) respectively. Intraoperative transfusion and rewarming and length of stay were independent predictors of cognitive impairment at one month postoperatively.(OR=8.48; 95% CI [1.19-60.56], P=0.033; OR=15.62, 95% CI [3.29-74.21], p=0.001 and OR=13.26; 95% CI [2.63-66.76], p=0.02) respectively.