Objective To analyze the clinical characteristics, treatment patterns, and prognostic factors of jaw cysts, so as to provide a reliable basis for formulating individualized clinical treatment plans. Methods A retrospective analysis was conducted on the clinical data of 92 patients with jawbone cysts admitted to Zhumadian Central Hospital from January 2022 to December 2025. Demographic information, clinical and pathological characteristics, treatment methods, and follow-up data of the patients were collected. The patients were divided into 42 cases in the group of fenestration decompression + second-stage curettage and 50 cases in the group of simple curettage based on the treatment mode. The clinical and pathological characteristics of the two groups were compared. According to the patient""s prognosis, they were classified into the recurrence group and the non-recurrence group. A multivariate Logistic regression model was used to analyze the influencing factors of prognosis. Results Regarding treatment patterns, 42 patients (45.65%) underwent decompression followed by secondary enucleation, while 50 patients (54.35%) received primary enucleation alone. The overall recurrence rate was 9.78% (9/92). Multivariate analysis identified a maximum lesion diameter＞3.5 cm, a diagnosis of odontogenic keratocyst, and treatment with primary enucleation alone were the independent risk factors for postoperative recurrence (all P＜0.05). Conclusion When formulating treatment strategies for jaw cysts, factors such as lesion size and pathological type should be comprehensively considered. For lesions with a diameter＞3.5 cm, decompression followed by secondary enucleation is recommended, as this approach yields more favorable prognostic outcomes.