Twenty years ago Aberg published his seminal studies on the neuropsychologic consequences of cardiopulmonary bypass (CPB). Twenty years later, what is the state of current research on the problem of post-CPB neurologic injury, and what different management techniques have been employed to influence this outcome? This article reviews the definition and assessment of postoperative neuropsychologic dysfunction; epidemiologic data and associated risk factors assessing post-CPB neuropsychologic dysfunction are critically appraised.