Introduction: Treatment of chronic subdural hematoma has improved dramatically in recent years because of advances in diagnosis and surgical techniques. However, there is still some debate regarding the best strategy for treatment. In our department, we have been using dexamethasone for the treatment of symptomatic chronic subdural hematoma. Through our study we intend to discuss effectiveness and safety of corticosteroid therapy in chronic subdural hematoma and its implications for the clinical practice. Materials and Methods: Upon admission, all patients were graded according to their functional neurological condition according to Markwalder Grading Score classification, patients scoring MGS 0-1-2 (alert, orientated and those drowsy or disorientated with possible variable neurological deficits) were assigned to the Dexamethasone Protocol whereas patients in MGS 3-4 (stuporous or comatose) were, in general, assigned to the Surgical Protocol. Some patients in grades 3-4 were also initially treated with dexamethasone as it is discussed below. For 20 patients under MGS 0,1 no treatment was instituted. No patient was left untreated in the case of severe neurological deterioration or due to extreme age. Non contrast cranial CT scan was used for initial diagnosis and follow up in all cases. Results: In Dexamethasone group only 1 (1 out of 20, 5%) patient deteriorated and was subjected to surgery, other 19 (95%) patient improved. In Patients where treatment was not administered in any form 14 (70%) patients had favourable outcome and 6 (30%) patients were subjected to surgery. Patients from MGS grade 1 and 2 who were treated with dexamethasone have better results as compared to not treated with any modality (95% vs 70%). Patients treated with dexamethasone along with surgery (94.28% had favourable outcome) had better outcome than patient who underwent only surgery (83.33% had favourable outcome). All patients readmitted (6.66%) did well. Mortality was very low for whole series (0.8%). Conclusion:This novel therapeutic approach to Chronic subdural haematoma opposes the traditional view of neurosurgeons that are prone to indicate early surgery supported by good results obtained in thousand of cases before. In early presentation with minimal neurological deficit; glucocorticoids reduce progression of disease and need of surgery. Thus, there is a role of medical treatment in a selected group of patients with CSDH. Well‑designed, multicenter, randomized controlled trials are required further to define the indications and standard protocols for the medical treatment of CSDH.