Most previous reviews have shown inconsistent results and fail to draw firm conclusions whether Ginkgo biloba has patient-relevant benefits in people with a diagnosis of dementia [7,8]. In the meantime, new studies have been published. A major limitation of the available Cochrane Review on the effectiveness of Ginkgo biloba is the combined evaluation of cognitive decline and dementia. No subgroup analyses were performed [7]. As no valid definition of cognitive impairment has been used, and given the finding of differential effects of other anti-dementia drugs on dementia and cognitive impairment [9], it appears no longer reasonable to pool these two indications. Furthermore, the uncertainty regarding mild cognitive impairment (MCI) as a clinical entity raises the question as to the scientific validity of MCI trials. In addition, the German Health Technology Assessment Institute IQWiG (Institute for Quality and Efficiency in Health Care) published a favorable report on the effectiveness of Ginkgo biloba, which was, however, limited to Alzheimer's disease and contradicted the Cochrane review [10]. Taking into account the overlap between different types of dementia [11] and the limited significance of dementia subtyping in routine use of anti-dementia drugs, there is no clear evidence for substantial differences in the effectiveness of those drugs in vascular or Alzheimer's dementia. As most anti-dementia drugs including ginkgo are prescribed without comprehensive assessment of the dementia subtype, and given continuing high prescription rates of ginkgo to people with an established dementia diagnosis in some countries, we felt that further decision support is necessary for this kind of routine use of the substance. Therefore, we performed a systematic review on the effects of Ginkgo biloba in Alzheimer's disease as well as vascular and mixed dementia covering a variety of outcome domains.