High-throughput proteomic analysis has identified specific plasma protein signatures that can predict cerebrovascular events in patients with cerebral small-vessel disease, a condition affecting the brain's smallest blood vessels. The research reveals distinct protein patterns linking vascular dysfunction, immune activation, and neuronal damage pathways to different disease manifestations. This proteomics approach represents a significant advance in cerebrovascular risk assessment, potentially enabling earlier intervention before clinical symptoms emerge. Previous biomarker research in this field has relied heavily on imaging and limited blood markers, making this comprehensive protein profiling particularly valuable. The identification of predictive plasma proteins could transform how clinicians monitor patients at risk for stroke and cognitive decline, two major consequences of small-vessel disease. However, the clinical utility will depend on validation in diverse populations and demonstration that protein-guided interventions improve outcomes. The convergence of vascular, immune, and neuronal pathway markers suggests these disease processes are more interconnected than previously understood, opening new therapeutic targets. For aging adults, this research offers hope for more precise risk stratification and personalized prevention strategies in cerebrovascular health.