ABSTRACT White matter hyperintensities (WMH) are very widespread in older adults and are imaging features of both cerebral small‐vessel disease and white matter microstructural impairments. Recent studies have demonstrated a close association between WMH and some common diseases in older adults, including Alzheimer's disease and hypertension. Thus, studies of WMH are important for avoiding the occurrence of these diseases and improving the health status of older adults. This review summarizes the literature relating to WMH in terms of epidemiology, clinical presentation, pathogenesis, imaging features, and therapy. It also analyzes the limitations of present studies and provides perspectives on future directions.