Aim:To investigate the risk factors associated with postoperative recurrence of septated chronic subdural hematoma (sCSDH) based on preoperative imaging manifestations and develop a nomogram model, aiming to provide a clinical prediction method for preventing sCSDH recurrence after surgery and serve a reference for selecting surgical approaches.Material and Methods:A total of 237 patients diagnosed with sCSDH were included in this study. Based on the recurrence status of the affected side during follow-up, patients were divided into a recurrence group (43 cases) and a non-recurrence group (194 cases) .The imaging-related factors influencing the recurrence of sCSDH after surgery were initially screened using univariate analysis, followed by multivariate logistic regression analysis to identify independent risk factors. A nomogram model was developed using R software, and internal validation was conducted using the boot-strap method.Results:The univariate analysis revealed that cerebral atrophy, bilateral hematoma, preoperative midline shift distance, sCSDH typing, Neovascularization, were the significant factors of postoperative recurrence for sCSDH. However, the multivariate logistic regression analysis identified encephalatrophy, bilateral hematoma, and Neovascularization as independent risk factors for sCSDH recurrence.Furthermore, the nomogram model analysis demonstrated a good discrimination with an AUC of 0.764 (95% CI: 0.6958-0.8322), while the P-value of Hosmer-Lemeshow test was 0.4382, indicating good consistenc. Conclusion:Encephalatrophy, bilateral hematoma, and neovascularization are independent imaging risk factors associated with sCSDH recurrence.The developed nomogram model is valuable for clinicians in assessing and identifying patients at a higher risk of sCSDH recurrence, enabling them to formulate appropriate diagnostic and treatment strategies.