Objective To investigate the influencing factors of chronic subdural hematoma with behavioral abnormality. Methods A total of 207 cases with chronic subdural hematomaadmitted to Deyang People's Hospital of Sichuan Province from January 2009 to October 2019 were retrospectively enrolled.All patients were divided into behavior abnormality group and non behavior abnormality group according to whether there was behavior abnormality. The general demographic data such as gender, age, history of trauma, smoking, drinking, cerebrovascular disease, hypertension, diabetes, hyperlipidemia, blood coagulation, Glasgow Coma Scale( GCS) score at admission, CT and cerebral perfusion imaging data at admission, including hematoma volume, hematoma location, hematoma density, CT midline displacement, falx hernia and cerebral perfusion defect. Mental examination was carried out by a professional psychosomatic physician, and Hamilton Depression Scale( HAMD), revised Wechsler Adult Memory Scale( WMS-RC) and Strength Scale( WAIS-RC) were tested.The scores of HAMD > 7 were regarded as depressive state, and the scores of memory quotient and total intelligence quotient < 79 were regarded as the judgment criteria of memory disorder and intelligence disorder. Logistic regression was used to analyze the independent risk factors of chronic subdural hematoma complicated with behavioral abnormality. Results The incidence of behavior abnormality in patients with chronic subdural hematoma was 73.43%( 152/207). According to single factor analysis, there was no significant difference in the incidence of behavior abnormality between the two groups on gender, age and history of coagulation abnormality( all P> 0.05); while the differences were statistically significant in history of trauma (χ2=8.763), history of smoking over 10 years( χ2=11.491), history of drinking over 10 years( χ2=14.365), history of cerebrovascular disease( χ2=11.492), history of hypertension( χ2=13.057), history of diabetes (χ2=9.534), history of hyperlipidemia( χ2=13.274), and disease course over 3 months( χ2=7.731), hematoma volume over 30 ml( χ2=12.763), hematoma location( χ2=21.458), hematoma density( χ2=8.736), CT midline shift( χ2=14.572), falx hernia( χ2=10.396), GCS under 8( χ2=7.216), and cerebral perfusion defect (χ2=6.781) between the two groups(all P < 0.05). Logistic regression analysis showed that history of trauma (OR=2.164,95%CI=1.083-2.934), history of smoking≥10 years( OR=2.346,95%CI=1.191-2.835), history of drinking ≥ 10 years(OR=2.941,95%CI=1.284-3.157), history of cerebrovascular(OR=3.178,95%CI=1.893- 4.597), history of hypertension ≥ 10 years(OR=2.783,95%CI=1.231-2.957), history of diabetes ≥ 10 years (OR=2.841,95%CI=1.309-3.637), history of hyperlipidemia(OR=3.237,95%CI=1.794-5.124), disease course ≥ 3 months(OR=3.957,95%CI=1.997-5.463), volume of hematoma ≥ 30 ml(OR=4.875,95%CI=1.982- 5.875), frontotemporal hematoma(OR=4.763,95%CI=1.898-5.968), mixed density hematoma(OR=4.537, 95%CI=1.795-5.362), CT midline displacement ≥ 5 mm(OR=4.876,95%CI=1.897-5.985),complicated with falx hernia(OR=4.495,95%CI=1.754-5.247), GCS < 8(OR=4.875,95%CI=1.897-5.876), frontotemporal cerebral perfusion defec(t OR=4.237,95%CI=1.651-4.896) were independent risk factors for chronic subdural hematoma complicated with behavioral abnormality. Conclusions Chronic subdural hematoma complicated with behavioral abnormality is affected by trauma, smoking, drinking, cerebrovascular disease, hypertension, diabetes, hyperlipidemia, course of disease, volume of hematoma, hematoma location, hematoma density, CT midline displacement, hernia, GCS, cerebral perfusion and other factors. Targeted early intervention may effectively reduce the occurrence of behavioral abnormality in chronic subdural hematoma.