〔Abstract〕 Objective To explore the efficacy of repeated transcranial magnetic stimulation treatment in cognitive dysfunction intervention after ischemic stroke. Methods A retrospective selection was conducted on 60 patients with cognitive dysfunction after ischemic stroke admitted to the Fifth Affiliated Hospital of Zhengzhou University from July 2022 to June 2023. According to different intervention methods, they were divided into two groups, conventional cognitive rehabilitation training group and repeated transcranial magnetic stimulation treatment group, with 30 cases in each group. The conventional cognitive rehabilitation training group received cognitive rehabilitation training, while the repeated transcranial magnetic stimulation treatment group received repeated transcranial magnetic stimulation treatment on the basis of cognitive rehabilitation training. The cognitive function, neurological function, quality of life, clinical efficacy and occurrence of adverse reactions were compared between the two groups. Results After intervention, the scores of Montreal cognitive assessment scale (MoCA), cognitive rating scale (CRS), and the stroke specific quality of life scale (SS-QOL) and the total scores of patients in the repeated transcranial magnetic stimulation treatment group were higher than those in the conventional cognitive rehabilitation training group, with statistical significance (P < 0.05). After intervention, the National Institutes of Health stroke scale (NIHSS) score of patients in the repeated transcranial magnetic stimulation treatment group was lower than that in the conventional cognitive rehabilitation training group, and the difference was statistically significant (P < 0.05). The total clinical effective rate of patients in the repeated transcranial magnetic stimulation treatment group was higher than that in the conventional cognitive rehabilitation training group, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients (P > 0.05). Conclusion In the intervention of cognitive dysfunction after ischemic stroke, the combination of cognitive rehabilitation training and repeated transcranial magnetic stimulation treatment has a significant therapeutic effect compared to the use of cognitive rehabilitation training alone.