Objective To investigate the clinical efficacy of endovascular therapy versus conventional anticoagulation therapy in the treatment of cerebral venous sinus thrombosis （CVST） and the benefits of patients， and to provide a reference for clinical work and achieve the goalof standardized diagnosis and treatment.Methods A retrospective analysis was performed for the patients with CVST who were admitted to our hospital from January 2017 to September 2020， and the patients were followed up by telephone for 3-46 months after discharge. Finally 115 patients with CVST were included in analysis， among whom 75patientsreceived endovascular therapy in addition to anticoagulation therapy and 40 patients received anticoagulation therapy alone. The two therapies were compared in terms of clinical efficacy and patient benefits.Results Both therapies significantly improved the prognosis of patients （P<0.001）. The patients receiving endovascular therapy in addition to anticoagulation therapy had a higher proportion of patients with good prognosis （mRS=0-2） than those receiving anticoagulation therapy alone （96.0% vs 87.5%， P>0.05）， and there was no significant difference in the proportion of patients with complete recovery （mRS=0） between the patients receiving endovascular therapy in addition to anticoagulation therapy and those receiving anticoagulation therapy alone （78.7% vs 77.5%， P>0.05）.The indices with statistical difference in general clinical data and the factors that had been confirmed to affect prognosis were adjusted as covariates， and it did not find that different therapies were associated with good prognosis （mRS=0-2） or complete recovery （mRS=0） （P>0.05）. There was a significant difference in median hospital costs between endovascular therapy+anticoagulation therapy and anticoagulation therapy alone （44 616.83 yuan vs 19 328.02 yuan， P<0.001）， while there was no significant difference in median length of hospital stay between endovascular therapy+anticoagulation therapy and anticoagulation therapy alone （16 days vs 15 days， P>0.05）.Conclusions Both endovascular therapy and anticoagulation therapy can significantly improve the prognosis of patients， but there isno significant difference between them. Endovascular therapy has higher hospital costs than anticoagulation therapy alone， and compared with anticoagulation alone， endovascular therapy does not reduce the length of hospital stay.