Objective To investigate the recanalization of cerebral venous sinus thrombosis (CVST) after anticoagulant therapy and its impact on long-term prognosis.Methods A total of 63 patients newly diagnosed with CVST were treated with anticoagulant therapy. The patients were re-examined with magnetic resonance imaging (MRI) combined with magnetic resonance venography (MRV) at the time of discharge and in the 3th, 6th, and 12th months after discharge. According to the results of MRI and MRV, the outcome of CVST was divided into complete recanalization, partial recanalization, and failure. The modified Rankin Scale (mRS) was used to assess the prognosis of patients. According to the mRS score, the patients were divided into complete recovery group (mRS=0) and incomplete recovery group (mRS=1-6), as well as good prognosis group (mRS≤2) and poor prognosis group (mRS>2). Logistic regression analysis was used to determine the impact of related factors on long-term prognosis.Results The recanalization rates at the time of discharge (18±4 days after anticoagulation) and in the 3th, 6th, and 12th months after discharge were 60%, 73%, 79%, and 81%, respectively. In the 12th month after discharge, 32 patients (51%) had complete recanalization, and 19 patients (30%) had incomplete recanalization; 39 patients (62%) recovered completely, and 24 patients (38%) recovered incompletely. Univariate analysis showed the age ≥40 years and non-recanalization were risk factors for incomplete recovery from CVST. Multivariate logistic regression analysis indicated that only age ≥40 years was the independent risk factor for incomplete recovery from CVST (odds ratio [OR]=5.995, 95% confidence interval [CI]: 1.195-20.922; P=0.023). Patients with complete recanalization had better prognosis than those without recanalization (hazard ratio [HR]=3.17, 95%CI: 1.8-10.43; P<0.001). Univariate analysis showed that age ≥40 years, male sex, and non-recanalization were risk factors for poor prognosis of CVST. Multivariate logistic regression analysis showed that only age ≥40 years was the independent risk factor for poor prognosis (OR=6.675, 95%CI: 2.195-8.922; P=0.035), while non-recanalization was not (OR=2.843, 95%CI: 0.87-13.472; P=0.11).Conclusions The recanalization of the occluded venous sinus caused by CVST is time-dependent, and patients with complete recanalization have better prognosis than those without recanalization.