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Background Middle meningeal artery embolization (MMAE) has emerged as an endovascular alternative or adjunct to surgical evacuation for chronic subdural hematoma (cSDH). Although multi-institutional data have established evidence based practice of MMAE of cSDH using liquid embolic, predictors of radiographic response after embolization remain incompletely characterized.Purpose To identify clinical factors associated with radiographic reduction in hematoma thickness following MMAE for cSDH.Materials and Methods We performed a retrospective single-center cohort study of consecutive patients undergoing MMAE for chronic or acute-on-chronic subdural hematoma. Patients treated with MMAE alone or combined with surgical decompression were included. The primary endpoint was percent change in maximal hematoma thickness. Multivariable forward stepwise linear regression was used to determine independent predictors of radiographic response.Results Forty-eight patients were included (mean age 71.7 ± 11.4 years; 70.8% male). Mean baseline maximal hematoma thickness was 15.6 ± 8.8 mm with mean midline shift of 4.1 ± 4.3 mm. Acute-on-chronic morphology was present in 75.0% of cases. On multivariable analysis, increasing age was independently associated with reduced hematoma thickness reduction (B = −1.92 per year; 95% CI −2.86 to −0.97; p = 0.001). Illicit drug use predicted diminished radiographic response (B = −40.6; 95% CI −68.78 to −12.42; p = 0.006). Conversely, coronary heart disease was associated with greater percent reduction in hematoma thickness (B = 23.65; 95% CI 4.19 to 43.11; p = 0.018).Conclusion Systemic vascular comorbidities may influence radiographic remodeling following MMAE. Coronary heart disease was associated with enhanced CT-based hematoma resolution, whereas advanced age and illicit drug use predicted diminished response.Disclosures G. Thrash: None. E. Wang: None. G. Stacey: None. H. Massie: None. P. Malenkia: None. J. Jones: 1; C; Johnson & Johnson, Scientia, TG Medical, Piraeus Medical, Medtronic.