Objective To explore the therapeutic effect of epidural layer stripping combined with artificial dural application in the treatment of Arnold-Chiari malformation type I with syringomyelia.Methods An analysis was performed on the clinical data of 86 cases of Arnold-Chiari malformation type I with syringomyelia； based on the treatment of the dura matter， the patients were divided into observation group （epidural layer stripping and artificial dural application， 32 cases）， control group 1 （intermittent incision of the epidural layer for decompression， 21 cases）， and control group 2 （expansive duraplasty， 33 cases）. The observation group and control groups were compared for differences in indices such as intraoperative ultrasound findings， operation duration， changes in spinal cavities， neurological function improvement， operation site infection， operation site effusion， cerebrospinal fluid （CSF） leak， and length of hospital stay.Results No patients in the three groups had any symptoms of new neurological deficit， postoperative paralysis， respiratory failure， or fatal outcomes. There were significant differences between the three groups in postoperative peak velocity of dorsal CSF， electrophysiological monitoring results， spinal cavity shrinkage， length of hospital stay， operation site infection， operation site effusion， and CSF leak （P <0.05）， but there were no significant differences between the three groups in neurological function improvement or operation duration （P >0.05）. In terms of postoperative peak velocity of dorsal CSF and spinal cavity shrinkage， there were significant differences between the observation group and the control group 1 （P <0.05） but not between the observation group and the control group 2 （P >0.05）. In terms of electrophysiological monitoring results， length of hospital stay， operation site infection， operation site effusion， and CSF leak， there were significant differences between the observation group and the control group 2 （P <0.05） but not between the observation group and the control group 1 （P >0.05）.Conclusions It is safer and more reliable， feasible， and effective to treat Arnold-Chiari malformation type I with syringomyelia using epidural layer stripping combined with artificial dural application compared with traditional treatment.