This meta-analysis aimed to compare clinical outcomes between  MMAE and surgery in patients with cSDH.

Chronic subdural haematoma (cSDH) is a common neurological condition, particularly among the elderly. The incidence is increasing globally. Surgical procedure is the most common approach for cSDH. Although middle meningeal artery embolisation (MMAE) has evolved as a minimally invasive alternative technique. For a better medical procedure.

The study was conducted through PubMed, Scopus, Web of Science and Cochrane until March 2025. Analysis was performed using the random-effects model. The outcomes measured were mortality, treatment failure, length of hospital stay, and reoperation. Results have been reported as risk ratios (RR) with confidence intervals (CI).

Five studies reported mortality rates of 3% with MMAE and 9.2% with surgery (RR = 0.74, 95% CI 0.40–1.39; p = 0.35). Treatment failure was significantly lower with MMAE (RR = 0.69, 95% CI 0.49–0.98; p = 0.039). No significant difference was found in hospital stay (MD = –1.39, 95% CI –3.46 to 0.69; p = 0.19) or reoperation rate (RR = 0.55, 95% CI 0.22–1.37; p = 0.19). Complication rates were comparable (RR = 1.01, 95% CI 0.77–1.32; p = 0.94).