We report a case of probable cerebral amyloid angiopathy (CAA) presenting with almost 100 cerebral microhemorrhages in an apolipoprotein E 4 (APOE4) homozygous subject with mild cognitive impairment (MCI). CAA is highly prevalent in autopsy studies and may impact over 100 million individuals worldwide; however, it remains substantially underdiagnosed clinically. Here, APOE is linked to Cognitive impairment.