ABSTRACT Background: Chronic subdural hematoma (CSDH) is a rising neurosurgical entity especially in elderly people. Objectives: To assess the value of using single burr hole craniostomy in the evacuation of chronic subdural hematoma according to the clinical picture. Methods: Prospective single-center study included 24 patients having CSDH. The postoperative outcome was assessed immediately after surgery in the ward, and then two weeks in the outpatient clinic for follow up. All patients underwent single burr hole craniostomy during the period between April 2018 to September 2018. Results: Our results were close to other reports. Epidemiologically, female to male ratio of 1:2.4 the main symptom was a headache (62.5. Disturbed conscious level (66.67%) was the main presenting sign. trauma was a commonest risk factor (45.8%) followed by hypertension and diabetes mellitus (20.83%) each. All patients had GCS above 11, over 83% of patients had a significant midline shift of above 5mm, which is significant for the complications and hospital stay. Most of the participants were Markwalder grade two (45.8%) followed by grade one (37.5%) before the operation, in comparison with Markwalder grade zero (79.2%) followed by grade one (12.5%) after the operation. High significant results were found between and the GOS and hospital stay, and between the GOS and GCS. Conclusion: single burr-hole craniostomy maneuver is comprehensive and safe management; having a short operating time with low recurrence and mortality rate.