Abstract: Objective To observe the recurrence of chronic subdural hematoma(CSDH)after trepanation and drainage and analyze the recurrence factors. Methods Clinical data of 120 patients with CSDH was analyzed retrospectively. All patients were followed up for more than 3 months after surgery to observe relapse condition and analyze relapse factors. Results The median follow-up time of 120 patients was 9 months after surgery, and 16(13.33%)of them relapsed and all underwent surgery again. There were statistically significant differences in preoperative anticoagulant application, hematoma density, preoperative midline shift, hematoma type, and postoperative drainage volume between patients with and those without recurrence(P<0.05). Conclusion Trepanation and drainage can effectively treat CSDH, but the postoperative recurrence rate is relatively high. The high-risk groups of hematoma recurrence should be identified early to carry out targeted intervention.