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Dementia with Lewy bodies (DLB) is a common form of dementia in the elderly and constitutes the second largest group of patients with degenerative dementia. To date, on the one hand, four cholinesterase inhibitors (ChEIs) have been approved for the treatment of Alzheimer’s disease (AD). On the other hand, there are no drug for approved for the treatment of DLB. However clinical benefits and good tolerability have recently been reported in several clinical trials of cholinesterase inhibitors (ChEIs), particularly donepezil. This review describes various aspects of donepezil, including basic pharmacology and pharmacokinetics, with the primary focus on the clinical work.