Moyamoya disease is a rare entity characterized by progressive narrowing of intracranial blood vessels. Moyamoya in most cases does not respond well to medical therapy and often leads to surgical revascularization. The physiological benefits of the surgery for Moyamoya patients have been well documented, yet the effects of surgery on cognitive skills are far less studied. Participants in the current study were 30 patients, 24 to 85 years of age, who underwent surgery and were all treated at Mayo Clinic in Jacksonville, Florida. All patients underwent a physical and cognitive preoperative evaluation, where speech, memory, and intellectual processes were measured. After the surgical intervention, patients returned for 3 follow-up assessments over a period of 6 months. All patients experienced stabilization or improvement of physiological symptoms. Regarding cognitive functions, speech, memory, and intellectual processes improved significantly after surgery. Further prospective studies are needed to better assess cognitive outcomes after revascularization for Moyamoya.