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Qiang Cai,1 Qiao Guo,1 Fan Zhang,2 Daofa Sun,2 Wenfei Zhang,1 Baowei Ji,1 Zhibiao Chen,1 Shanping Mao3 1Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, China; 2Department of Neurosurgery, Xiantao First People’s Hospital, Xiantao, Hubei Province 433000, China; 3Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, China Objective: To evaluate the effectiveness and safety of neuroendoscopic surgery for chronic or subacute subdural hematoma. Patients and methods: Between September 2016 and September 2018, neuroendoscopic surgery was performed on 25 patients with chronic and subacute subdural hematoma. Hematoma evacuation was performed with a 0°, 4 mm diameter rigid neuroendoscope via a transcranial neuroendoscopic approach. Results: All patients successfully underwent neuroendoscopic surgery, and no surgical complications or rebleeding was observed. Postoperative computed tomography scans showed that the hematoma was successfully evacuated. All patients had recovered well at discharge, the observed 30-day mortality rate was 0%, and no patients suffered recurrence for 2–26 months after surgery. Conclusion: Neuroendoscopic surgery was a safe and effective approach for the treatment of chronic and subacute subdural hematoma. This approach has the advantages of decent visualization and minimal invasiveness and could reduce recurrence and the mortality rate. Keywords: subacute subdural hematoma, chronic subdural hematoma, transcranial neuroendoscopic approach