Objective To compare and analyze the symptoms of patients with chronic subdural hematoma treated with small bone window craniotomy hematoma removal and drilling and drainage, and the recurrence after surgery. Method A total of 85 patients with chronic subdural hematoma treated in our hospital from January 2014 to March 2020 were selected as study subjects, and divided into an observation group and a control group according to the treatment Methods provided. The observation group was treated with in-window craniotomy, while the control group was treated with drilling and drainage surgery. Comparisons of the symptoms and recurrence were made between of the two groups. Results There was no significant difference in symptom improvement between the two groups of patients after respective surgical treatments (P>0.05); there was also no significant difference in the incidence of complications after surgery between the two groups of patients. The observation group showed a significantly lower recurrence rate than the control group (P<0.05). Conclusion Both small bone window craniotomy hematoma removal and drilling and drainage have certain therapeutic effects on chronic subdural hematoma, and effectively alleviate patient’s symptoms. Small bone window craniotomy hematoma removal can produce a lower recurrence rate; therefore, it is worthy of popularization and application in clinical treatment.