As of March 2023, approximately 1.879 million individuals in the UK self-assessed as having long COVID, with around 42% experiencing symptoms lasting two years or more. Systematic reviews and meta-analyses report that up to a third of these individuals have persistent cognitive impairment, though estimates vary due to methodological heterogeneity. The underlying pathological mechanisms and potential treatments for cognitive impairment in long COVID are uncertain, with most evidence being mechanistic, observational, or hypothetical. Cognitive performance is typically assessed across various domains, including memory, attention, and executive functioning, with many patients showing deficits in multiple areas. These symptoms can significantly impact daily life, relationships, and work, and they fluctuate unpredictably, causing uncertainty and anxiety. Patients often struggle to explain their cognitive problems to others, as they are often invisible and difficult to understand. Practical strategies, such as using analogies to describe energy levels and managing cognitive load, can help patients cope with their symptoms. Primary care providers play a crucial role in supporting patients by providing longitudinal support, encouraging self-management, and managing comorbid conditions. For severe or persistent cognitive impairment, referral to specialist multidisciplinary services is recommended. While there is no definitive evidence for effective drug treatments, ongoing research and clinical trials are exploring various therapeutic options. The article also includes patient accounts and resources for both patients and professionals, emphasizing the importance of patient involvement in the creation of the guidance.As of March 2023, approximately 1.879 million individuals in the UK self-assessed as having long COVID, with around 42% experiencing symptoms lasting two years or more. Systematic reviews and meta-analyses report that up to a third of these individuals have persistent cognitive impairment, though estimates vary due to methodological heterogeneity. The underlying pathological mechanisms and potential treatments for cognitive impairment in long COVID are uncertain, with most evidence being mechanistic, observational, or hypothetical. Cognitive performance is typically assessed across various domains, including memory, attention, and executive functioning, with many patients showing deficits in multiple areas. These symptoms can significantly impact daily life, relationships, and work, and they fluctuate unpredictably, causing uncertainty and anxiety. Patients often struggle to explain their cognitive problems to others, as they are often invisible and difficult to understand. Practical strategies, such as using analogies to describe energy levels and managing cognitive load, can help patients cope with their symptoms. Primary care providers play a crucial role in supporting patients by providing longitudinal support, encouraging self-management, and managing comorbid conditions. For severe or persistent cognitive impairment, referral to specialist multidisciplinary services is recommended. While there is no definitive evidence for effective drug treatments, ongoing research and clinical trials are exploring various therapeutic options. The article also includes patient accounts and resources for both patients and professionals, emphasizing the importance of patient involvement in the creation of the guidance.