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Objective To explore whether different drainage methods have positive effects on HIV positive patients with cryptococcal meningitis (CM). Methods From January 2017 to December 2019, 40 patients with HIV positive CM were treated in the Department of Infectious Diseases of the First Affiliated Hospital of Guangxi Medical University and Nanning Infectious Diseases Hospital Affiliated to Guangxi Medical University. 20 patients with continuous lumbar drainage were selected as the observation group and 20 patients with regular lumbar puncture drainage were enrolled into the control group. The clinical manifestations, CD4 count, cerebrospinal fluid examination and cryptococcal ink staining results of patients before and after treatment were recorded. Results There was no significant difference in general data between the two groups before treatment (P>0.05). After treatment, the white blood cell count [(28.70±12.04)x106/L vs(68.80±34.71)x106/L] and protein content [(477.25±198.61)mg/L vs(712.15±427.89)mg/L] in cerebrospinal fluid decreased significantly in the observation group, and similar results were found in the control group (P<0.001). The CD4 count [observation group(31.30±22.00)cells/μL, control group(27.70±20.18)cells/μL], cerebrospinal fluid sugar [observation grou(3.41±0.62)mmol/L, control group(2.80± 0.77)mmol/L] and chloride [observation group(127.78±9.47)mmol/L, control group(125.25±8.03)mmol/L] in the two groups were significantly higher than those before treatment (P<0.05). There were significant differences in CD4/CD8, leukocyte count and sugar content between the two groups (P<0.05). After treatment, the symptoms of headache and nausea/vomiting in the observation group were better than those in the control group. Finally, continuous lumbar drainage was effective in 15 cases and ineffective in 5 cases, regular lumbar puncture drainage was effective in 7 cases. Conclusion In the treatment of cryptococcal meningitis, continuous lumbar drainage can quickly relieve clinical symptoms, accelerate the renewal of cerebrospinal fluid and shorten the clearance time of pathogens, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]