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Introduction Middle meningeal artery embolization (MMAE) has emerged as an effective treatment for chronic subdural hematoma (cSDH). Though initial studies employed either particle or liquid embolics, coil embolization may provide a viable alternative. However, comparative data on the clinical efficacy of coil embolization versus traditional embolics in this domain are limited. We present a retrospective study comparing the effectiveness and procedural characteristics of SwiftPAC coils (Penumbra Inc., Alameda, CA, USA) to Onyx liquid embolic (Medtronic PLC, Minneapolis, MN, USA) and polyvinyl alcohol (PVA) particles in the treatment of cSDH.Methods A retrospective analysis was conducted on consecutive patients undergoing MMAE at a single institution from July 2019 to July 2025. Data for baseline patient demographics, pre-operative hematoma characteristics, procedural characteristics, and follow-up radiographic metrics are described. The choice of embolic agent was at the discretion of the treating neurointerventionalist. Statistical comparisons employed Fisher’s exact test for categorical variables and the Kruskall-Wallis test for continuous variables.Results The cohort comprised a total of 112 patients undergoing 135 MMAE. Patients were mostly men (73.7%) with an average age of 72 years. Baseline clinical and radiographic characteristics were comparable across groups. The majority of MMAE was performed as an adjunct to surgical evacuation (67.9%). Embolic groups included Onyx (n = 68), PVA (n = 31), SwiftPAC coils (n = 21), or SwiftPAC coils + PVA (n = 15). On average, deployment of SwiftPAC coils was 10 minutes slower (p = 0.03) and added 4 minutes of fluoroscopy time (p = 0.015) compared to Onyx, but 23 minutes faster (p = 0.004) and used 13 minutes less fluoroscopy time (p = 0.002) than PVA. Compared to other embolic agents, SwiftPAC coils showed similar percent reduction in cSDH thickness (p = 0.499) and rate of 100% cSDH resolution (p = 0.159) over a median follow-up of 70 days. Notably, the addition of PVA to SwiftPAC coils did not increase the proportion of 100% resolution (p= 0.97) or percent change in cSDH at final follow up (p = 1.00) but was associated with significantly higher procedural radiation (p < 0.001) and procedure time (p < 0.001).Conclusion SwiftPAC coils are a novel embolic agent that provide a comparable cSDH treatment effect with rapid procedural times and low fluoroscopic exposure. These findings suggest that SwiftPAC coils may be an effective, stand-alone alternative to current embolics, though larger studies will need to expound on the comparative efficacy of this agent and other methods of coil embolization in long-term follow up.Disclosures K. Shaffer: None. M. Ning: None. A. Le: None. M. Zahed: None. A. Padir: None. M. Lafuente: None. M. Gaub: None. M. Webb: None. F. Al Saiegh: None. L. Birbaum: 2; C; Imperative Care. J. Mascitelli: 2; C; Stryker, Imperative Care.