Objective To evaluate the role of closed drainage via minimally invasive drilling in the treatment of chronic subdural cerebral hematoma.Methods One hundred and twenty-four patients with chronic subdural cerebral hematoma who were enrolled after meeting inclusion criteria were randomly divided into group A (drainage with a single burr hole) and group B (drainage with two burr holes). Outcome measures including operative time, time to extubation, length of hospital stay, rate of pneumocrania, recurrence rate of hematoma, Barthel Index (BI), and Glasgow Outcome Scale (GOS) score were compared between the two groups.Results Group A had significantly shorter operative time and length of hospital stay than group B (P<0.01). Pneumocrania occurred less frequently in group A than in group B (P<0.05), and the recurrence rate of hematoma was not statistically significant between the two groups (P>0.05). The BI and GOS score were significantly lower in group A than in group B (P<0.01).Conclusions Closed drainage via minimally invasive drilling (single or two burr holes) is an effective procedure for the treatment of chronic subdural cerebral hematoma. Closed drainage with a single burr hole is superior to closed drainage with double burr holes in terms of operative time, length of hospital stay, and rate of pneumocrania, whereas closed drainage with double burr holes offer greater benefits in neurological rehabilitation at the three-month follow-up.