Objective To evaluate the efcacy and safety of middle meningeal artery (MMA) embolization in the treatment of acute traumatic epidural hematoma (ATEDH). Methods The data of 40 patients with ATEDH, who received MMA embolization from Jan. 2010 to Jan. 2020 in the Stroke Center of Changhai Hospital of Naval Medical University (Second Military Medical University), were retrospectively analyzed. The patients underwent digital subtraction angiography (DSA)+MMA embolization under local anesthesia within 24 h of onset. After the embolization, drug treatment, burr-hole drainage or hematoma evacuation by craniotomy were given according to the consciousness and the hematoma volume. The patients were followed up for 6 months to observe postoperative disease condition, absorption of hematoma and complications. Results There were 21 males and 19 females in the 40 ATEDH patients (aged from 16 to 68 years). The Glasgow coma scale (GCS) score on admission ranged from 13 to 15 in 25 patients and from 9 to 12 in 15 patients. Cerebral angiography showed that MMA was the bleeding artery in the 40 patients, and the bleeding stopped immediately after MMA embolization. Eight patients were treated with simple MMA embolization, 32 patients were treated with burr-hole drainage after MMA embolization, and no patients received craniotomy. At discharge, the GCS scores of all the 40 ATEDH patients were 15, and the clinical symptoms such as headache, nausea and vomiting were improved compared with those at admission. Six months after operation, no hematoma developed or recurred, and the score of Glasgow outcome scale-extended was 8 in all the patients. During the follow-up, no operation-related complications such as infection, ischemic stroke or neurological dysfunction were noticed. Conclusion MMA embolization can effectively control the progress of ATEDH, reduce the risk of rebleeding, and prevent patients from undergoing further surgical invasive intervention.