Objectives: To compare the outcomes of surgical treatment of chronic subdural hematomas using high-speed drill craniostomy with other surgical methods, focusing on hospitalization duration, incidence of postoperative complications (local and systemic infections, hemorrhage, hematoma recurrence, epilepsy, thromboembolism), and overall treatment outcome. Study Design: Cross-sectional study. Participants and methods: This study included 124 patients surgically treated for CSDH at the Department of Neurosurgery, Osijek Clinical Hospital Center over a five-year period (November 2018 - October 2023). Patients were divided into two groups: those treated with HSD craniostomy and those treated with other surgical methods. Analyzed parameters included demographic data, presence of bilateral lesions, hospitalization duration, co-morbidities, use of anticoagulant and antiplatelet therapy, complications and treatment outcome. Results: Out of 124 patients, 92 (74.2 %) were male and 32 (25.8 %) were female. The median age was 76 years. High speed drill craniostomy was performed on 44 (35.5 %) of patients, while 80 (64.5 %) were treated with other surgical methods. High speed drill craniostomy was significantly more common in men. Patients treated with other methods were significantly younger. Most patients (85 or 66 %) suffered from arterial hypertension, 20 (16 %) had diabetes, and 12 (10 %) were chronic alcoholics. Anticoagulant therapy was taken by 22 (18 %) of patients, and antiplatelet therapy by 16 (13 %). The incidence of complications and associated comorbidities were not related to the chosen treatment method. Patients who underwent local anesthesia were significantly younger than those operated in general anesthesia. Hospitalization duration was not associated with anesthesia type or patient age. Ten patients (8 %) died, with no significant difference between treatment methods. Conclusion: High speed drill craniostomy is valid method for treating chronic subdural hematomas in comparison to other surgical methods, with the advantage of being performed under local anesthesia.