Objective:To analyze the clinical efficacy of middle meningeal artery(MMA)embolization and analyze the in-fluencing factors for postoperative recurrence in patients with chronic subdural hematoma(CSDH).Methods:According to coin-tossing method,100 patients with CSDH were divided into group A(MMA embolization)and group B(minimally invasive puncture and drainage),50 cases in each group.All patients were followed up for 3 months after surgery.The thickness of sub-dural hematoma,surgical and postoperative rehabilitation(operation time,length of hospital stay,absorption rate of hematoma,midline improvement)before surgery,after surgery and at 3 months after surgery were compared between the two groups.At 3 months after surgery,patients were divided into recurrence group(n=15)and non-recurrence group(n=85)according to presence of absence of CSDH recurrence,basic clinical information,preoperative midline shift,treatment regimens,midline im-provement,days of atorvastatin and glucocorticoid treatment,scores of Glasgow Coma Scale(GCS)and modified Rankin Scale(MRS),and neutrophils in the two subgroups were compared.To systematically analyze potential factors of CSDH recurrence,binary Logistic regression analysis was applied in multivariate statistical modeling.Results:The comparison of hematoma thick-ness in group A before operation>after operation>3 months after operation,and that in group B before operation>3 months after operation>after operation showed significant differences(P<0.05).Compared between the two groups,the thickness of subdural hematoma in group A was higher than that in group B after operation,and it was lower than that in group B at 3 months after operation.There were significant differences between the two groups in terms of time,time and interaction(P<0.05).The length of hospital stay and operation time in group A were shorter than those in group B,absorption rate of hematoma and midline improvement were higher than those in group B at 3 months after surgery(P<0.05).The preoperative hematoma volume,midline shift and operation time in non-recurrence group were lower than those in recurrence group,and pro-portion of MMA embolization was higher than that in recurrence group(P<0.05).Logistic regression analysis showed that preoperative hematoma volume and midline shift were independent risk factors of recurrence in CSDH patients(P<0.05),while MMA embolization was a protective factor(P<0.05).Conclusion:MMA embolization can reduce thickness of subdural hematoma,shorten operation time and length of hospital stay,promote postoperative hematoma absorption and improve brain midline shift.Meanwhile,MMA embolization,preoperative hematoma volume and midline shift are influencing factors of recur-rence in CSDH patients.