Huperzine A, an acetylcholine esterase (AChE) inhibitor used to treat cognitive disorders, is promising in improving the postoperative cognitive function.<h4>Objective</h4>To assess the efficacy of huperzine A injection on improving early postoperative cognitive function in patients undergoing neurosurgical procedures under general anesthesia.<h4>Design, setting, and participants</h4>This parallel-group, randomized trial was conducted at a neurosurgical department of a tertiary hospital in China from May, 2021 to February, 2023. The gene discussed is ACHE; the disease is Cognitive impairment.