Objective To investigate the efficacy of Y-shaped double-lumen drainage tube combined with continuous perfusion versus single-lumen drainage tube alone in the treatment of elderly patients with subacute subdural hematoma.Methods A total of 28 elderly patients with subacute subdural hematoma who were admitted to our hospital and underwent surgical treatment from January 2013 to December 2015 were enrolled and randomly divided into Y-shaped double-lumen drainage tube plus continuous perfusion group (17 patients) and single-lumen drainage tube group (11 patients). The midline shifts of the OM line on the 5th level at 1, 2, 3, and 14 days and 3 months after surgery were compared between groups, and the time for drainage liquid to return to normal and recurrence rate were compared between groups.Results The midline shift showed no significant differences between the Y-shaped double-lumen drainage tube plus continuous perfusion group and the single-lumen drainage tube group before surgery and at 1 day after surgery, but showed significant differences at 2, 3, and 14 days and 3 months after surgery. In the treatment group, the time for drainage liquid to become clear was 1.9±0.5 days, and no patient experienced recurrence; in the control group, the time for drainage liquid to become clear was 3.7±1.4 days, and 2 patients experienced recurrence. The time for drainage liquid to become clear and recurrence rate showed significant differences between the two groups (P<0.05).Conclusions Y-shaped double-lumen drainage tube combined with continuous perfusion is a safe, simple, and reliable method for subacute subdural hematomas.