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Whether obstructive sleep apnea (OSA) is associated with alterations in the limbic white matter tracts remains understudied.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Polysomnography, neurocognitive assessment, and brain magnetic resonance imaging (MRI) were performed in 126 individuals aged 55\u201386 years, including 70 cognitively unimpaired participants and 56 participants with mild cognitive impairment (MCI). OSA measures of interest were the apnea\u2010hypopnea index and composite variables of sleep fragmentation and hypoxemia. Microstructural properties of the cingulum, fornix, and uncinate fasciculus were estimated using free water\u2010corrected diffusion tensor imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Higher levels of OSA\u2010related hypoxemia were associated with higher left fornix diffusivities only in participants with MCI. Microstructure of the other white matter tracts was not associated with OSA measures. Higher left fornix diffusivities correlated with poorer episodic verbal memory.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>OSA may contribute to fornix damage and memory dysfunction in MCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Sleep apnea\u2010related hypoxemia was associated with altered fornix integrity in MCI.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Altered fornix integrity correlated with poorer memory function.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Sleep apnea may contribute to fornix damage and memory dysfunction in 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