〔Abstract〕 Objective To explore hematoma recurrence and risk factors after neuroendoscopy in patients with chronic subdural hematoma, to provide reference for improving patient prognosis. Methods A retrospective study was conducted on 190 patients diagnosed with chronic subdural hematoma in Kaifeng Central Hospital from September 2018 to January 2022 who underwent neuroendoscopic treatment. They were divided into a recurrent group (21 cases) and a non-recurrent group (169 cases) based on the difference in their follow-up results for 12 months, using a multivariate logistic regression model to analyze the risk factors for hematoma recurrence in patients undergoing neuroendoscopic treatment for chronic subdural hematoma. Results Hematoma recurred in 21 of 190 patients, with a recurrence rate of 11.05 % and no recurrence in 169 patients. The results of univariate analysis showed that there were statistically significant differences between the two groups in postoperative residual gas volume, abnormal coagulation function, postoperative statin use, hematoma side, hematoma density and preoperative hematoma thickness (P < 0.05). Multivariate logistic regression analysis showed that abnormal coagulation function, no postoperative statin therapy, high-density hematoma, bilateral hematoma, and preoperative hematoma thickness > 25 mm were independent risk factors for hematoma recurrence after neuroendoscopy of chronic subdural hematoma (P < 0.05). Conclusion The recurrence rate of chronic subdural hematoma after neuroendoscopy is relatively high, among which abnormal coagulation function, no postoperative statin, high-density hematoma, bilateral hematoma, and preoperative hematoma thickness > 25 mm are independent risk factors for recurrence. It is recommended to actively carry out follow-up intervention for patients with these risk factors to improve the prognosis of patients.