Abstract: Objective： To investigate the clinical effect of gradually controlled decompression in the treatment of acute subdural hematoma complicated with brain contusion. Methods： Among the 365 ASDH patients complicated with cerebral contusion who require decompression surgery, 195 cases of the observation group underwent progressive decompression operation, and 170 cases of the control group underwent conventional standard large bone flap decompression operation. The Glasgow Outcome Scale (GOS) scores three months after the operation were compared between the two groups, and intraoperative and postoperative complications were observed. Results： Acute intraoperative encephalocele, delayed intracranial hematoma, brain stem displacement, massive cerebral infarction, postoperative intracranial hypertension and intraoperative hypotension, and the prognosis of two groups were compared, and the differences were all statistically significant (P< 0.05). Conclusions： The gradually controlled decompression surgery can effectively reduce intraoperative and postoperative complications, disability and mortality in ASDH patients complicated with cerebral contusion, so it is an effective surgical method.