Traditionally overshadowed by cerebral pathology in neurodegenerative diseases, the cerebellum has emerged as a critical player in cognitive decline and dementia, as evidenced by mounting clinical and biological data linking its dysfunction to disease progression. Indeed, Devita et al.'s works illuminate this paradigm shift by integrating neuroimaging, clinical correlations, and reserve mechanisms to position the cerebellum as an early biomarker and modulator in dementia. In their narrative review, Devita and colleagues synthesize structural and functional evidence, revealing disease-specific cerebellar atrophy patterns across Alzheimer’s, frontotemporal, and vascular dementias that correlate with executive, affective, and linguistic impairments previously mainly associated to the Cerebellar Cognitive Affective Syndrome. Complementing this, their 2024 study pioneers empirical evidence on cognitive reserve's protective effects on cerebellar volumes in older adults with mild cognitive impairment, leveraging advanced MRI parcellation to uncover novel links between reserve proxies and preserved structure. Consequently, this protective association underscores the cerebellum's dynamic involvement in early cognitive decline, with volume-performance correlations evolving across preclinical stages to manifest impairment. Therefore, these findings collectively advocate for cerebellar assessment in routine clinical evaluations of at-risk populations, enhancing early detection strategies in dementia management.