A prospective study of span of 3 years in 50 patients, with acute on chronic subdural hematoma will be treated with evacuation of clot by mini craniotomy & by burr hole from august 2022 to august 2024.The approach will be done by mini craniotomy approximately 4.5×3.5 cm in the most dependent part over fronto-parietal convexity in 25 patients. In 25 patients, the approach will be done by Burr Hole technique in the most dependent part. Our study shows that minicraniotomy is better and much superior to burr hole procedure in acute on chronic SDH patients because of following points-large and better visualization of surgical field, removal of maximum subdural membranes, complete or near total evacuation of hematoma, better haemostasis, lesser recurrence and provide better functional outcome due to thorough removal of hematoma, which provide faster neurological recovery and better rehabilitation as compared to burr hole.