Background: Chronic subdural hematoma (cSDH) remains a significant neurosurgical challenge, with ongoing debate regarding optimal surgical management. This study compared the outcomes of burr hole craniostomy (BHC) versus minicraniotomy (MC) in treating cSDH. Methods: A retrospective analysis of 100 consecutive patients with unilateral cSDH was conducted between October 2022 and January 2024. Patients were divided into BHC (n=49) and MC (n=51) groups. Outcomes were assessed using the Landriel Ibañez grading system for complications, recurrence rates, and 30-day mortality. Results: Mean patient age was comparable between groups (BHC: 72.6±14.2 years, MC: 72.9±12.4 years). Overall complication rates were lower in the BHC group (14.3% vs 21.6%), while recurrence rates were higher (12.2% vs 5.9%, p=0.09). The 30-day mortality rates were similar (BHC: 2.0%, MC: 1.9%, p=0.50). Neurological outcomes were comparable, with mean GCS scores at discharge of 14.4 and 14.3 for BHC and MC groups respectively (p=0.07). Grade Ib complications were most common in both groups (BHC: 6.1%, MC: 9.8%). Conclusion: While both techniques demonstrated acceptable safety profiles, BHC showed lower complication rates but higher recurrence tendency, whereas MC exhibited lower recurrence rates but higher complications. These findings suggest that surgical approach selection should be individualized based on patient characteristics and hematoma features.