Background: There are many cognitive tests that detect mild cognitive impairment (MCI) and dementia such as the Montreal Cognitive Assessment (MoCA) and Rowland Universal Dementia Assessment Scale (RUDAS). The comparative performance of these screening tests for identifying MCI and dementia is unknown. Methods: The MoCA and RUDAS were administered during baseline visits for patients in the Calgary Neurosciences Program. Those that enrolled in the Prospective Registry of Persons with Memory Symptoms (PROMPT) had their scores related to their final clinical diagnosis. Cut-off scores of 26 for the MoCA and 22 for the RUDAS were used to indicate a positive result. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of both cognitive scores were compared. Results: The sensitivity, specificity, PPV, NPV, and accuracy of the MoCA (n = 125) was 89.3%, 72.7%, 93.9%, 59.3%, and 86.4%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of the RUDAS (n = 125) was 47.6%, 100%, 100%, 29.0%, 56.8%, respectively. Conclusions: In patients with cognitive complaints presenting to a specialist clinic, the MoCA was more sensitive and accurate than the RUDAS for a final clinician diagnosis of mild cognitive impairment or dementia when using the standard cut-offs.