Aim:Chronic subdural hematoma (CSH) is a commen type of intracranial hemorrhage in elderly patients. Despite improved medical diagnosis and treatment, the reoperation rate remains high. Here we aimed to identify risk factors predict CSH recurrence.Material and Methods:A retrospective review of 291 CSH patients admitted to our department was performed. Clinical and radiological factors predictive for CSH recurrence were identified by univariable analyses; variables whose p-value was <0.05 underwent multivariate logistic regression analyses.Results:Univariate analyses revealed that preoperative midline shift (p = 0.025), mix-density hematoma (p = 0.023), internal architecture of hematoma (p = 0.044), membranectomy (p = 0.001), and ambient cistern compression (p = 0.001) correlated with a significantly higher rate of recurrence. Multivariate analyses showed that separated architecture, membranectomy and ambient cistern compression were independent risk factors for CSH recurrence.Conclusion:Among many factors, membranectomy, separated architecture, and ambient cistern compression were the strongest predictors for recurrence.