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Chronic subdural hematoma (CSDH) is a common disease in neurosurgery. Middle meningeal artery embolization (MMAE) combined with subdural drainage has become the mainstream treatment option, significantly reducing surgical trauma and hospitalization time. However, in clinical practice, a certain proportion of patients still experience postoperative recurrence, which not only affects patient prognosis but also increases the burden on medical care. Currently, the risk factors for recurrence after this combined surgical procedure have not been fully identified, and there is an urgent need for in-depth research to provide scientific evidence for clinical intervention. To investigate the risk factors for recurrence in patients with CSDH after MMAE combined with subdural drainage and to establish a predictive model. A total of 211 patients were included in this study, among whom 35 patients experienced postoperative hematoma recurrence. The patients enrolled in this study were randomly divided into a training set and a validation set in a 7:3 ratio, with 147 patients in the training set and 64 patients in the validation set. This study collected patients' medical histories, onset conditions, and relevant information during hospitalization to study the factors affecting recurrence in patients with CSDH after MMAE combined with subdural drainage, and established a predictive model. Potentially relevant factors were included in univariate logistic regression analysis, and the results showed that gender, postoperative drainage volume, postoperative statin use, postoperative hyperbaric oxygen therapy, admission Glasgow Coma Scale score, and preoperative hematoma volume were potential risk factors for recurrence in patients with CSDH who underwent MMAE combined with subdural burr hole drainage, P < .2. Further inclusion of the obtained data in a multivariate retrospective analysis revealed that postoperative drainage volume, postoperative hyperbaric oxygen therapy, admission Glasgow Coma Scale score, and preoperative hematoma volume were independent risk factors for recurrence in patients with CSDH who underwent MMAE combined with subdural burr hole drainage (P < .05). The predictive model developed in this study can help neurosurgeons accurately identify high-risk CSDH patients who are likely to experience recurrence after MMAE combined with subdural burr hole drainage.