The Monte Carlo method was used for QSAR modeling of dimeric pyridinium compounds as acetylcholine esterase inhibitors. QSAR model was developed for a series of 39 dimeric pyridinium compounds. QSAR models were calculated with the representation of the molecular structure by the simplified molecular-input line-entry system. One split into the training and test set have been examined. The statistical quality of the developed model is very good. The calculated model for dimeric pyridinium derivatives had following statistical parameters: r (2) = 0.9477 for the training set and r (2) = 0.9332 the test set. Structural indicators considered as molecular fragments responsible for the increase and decrease in the inhibition activity have been defined. The computer-aided design of new dimeric pyridinium compounds potential acetylcholine esterase inhibitors with the application of defined structural alerts has been presented.