Objective To investigate the efficacy of anticoagulation alone and combined endovascular therapy for cerebral venous sinus thrombosis (CVST). Methods Patients with CVST who received anticoagulation alone or combined endovascular therapy in The Affiliated Ganmei Hospital of Kunming Medical University between January 2013 and June 2019 were retrospectively collected. A total of 39 patients were eligible for inclusion,including 19 in the simple anticoagulation group (Conservative Group) and 20 in the combined group (Surgical group). The incidence of adverse reactions,the rate of vascular recanalization and the rate of good outcome were compared between the two groups. Differences in Glasgow Coma Scale(GCS),a modified Rankin Scale (mRS). Results The discharge GCS score of the combined group and the Conservative Group was higher than that of the admission group,and the difference was statistically significant (P＜0.05). The vascular recanalization rate of the combined group was significantly higher than that of the Conservative Group,and the difference was statistically significant (P＜0.05),while the incidence of adverse reactions was not statistically significant (P＞0.05). The rate of good outcome in the combined group was significantly higher than that in the Conservative Group,with statistical significance (P＜0.05). The mRS score of the combined group at discharge,3 months after discharge and 6 months after discharge was significantly lower than that of the Conservative Group,with statistical significance (P＜0.05). Conclusion Anticoagulant combined with endovascular treatment for severe CVST patients may have better prognosis after discharge,which can be used as a standby method for patients with poor efficacy after treatment alone.