Objective To investigate the clinical features and operative methods of organized chronic subdural hematoma (OCSDH).Methods The clinical data of four patients undergoing surgery for OCSDH from January 2014 to June 2018 were analyzed retrospectively.Results The clinical manifestations of OCSDH were intracranial hypertension and focal neurological damage. Two out of the four patients were treated with borehole drainage, which was not effective, followed by bone flap craniotomy hematoma removal. The other two patients were directly treated with bone flap craniotomy hematoma removal. Among them, three patients underwent complete resection, and one patient had residual visceral envelope. There were no surgical deaths. All patients received oral atorvastatin after surgery. During the follow-up period from 6 months to 4 years, all patients recovered well and no recurrence occurred.Conclusions The treatment outcome for OCSDH can be significantly improved by carefully analyzing imaging data before surgery, adopting a reasonable therapeutic strategy during surgery, and receiving oral atorvastatin after surgery.