This review thoroughly examines the complex interplay between remazolam administration and postoperative cognitive dysfunction (POCD), offering a detailed analysis of POCD's pathogenesis and the pharmacological mechanisms underpinning remazolam's effects. It critically synthesizes existing research findings, highlighting the nuanced nature of the association between remazolam use and POCD. While recognizing the widespread use of remazolam as a sedative, this review identifies its potential to increase susceptibility to POCD, particularly in vulnerable groups such as elderly patients or those exposed to prolonged or high-dose administration. However, it underscores the variability in research outcomes, necessitating a deeper exploration. The review underscores the necessity for tailored guidelines on remazolam administration and advocates for holistic POCD prevention strategies, integrating pharmacological measures with complementary non-pharmacological approaches to enhance patient safety. The review emphasizes the need for rigorous future research, including randomized controlled trials and longitudinal studies, to unravel the intricate dynamics between remazolam use and POCD, providing clinicians with robust evidence to guide optimal patient care.