BACKGROUND: Survivors of herpes simplex encephalitis (HSE) commonly experience significant neurological sequelae, imposing a substantial burden on both society and families. The efficacy of glucocorticoids in treating patients with HSE remains controversial. This study aims to evaluate the effectiveness of glucocorticoids in patients with HSE and analyze the clinical characteristics of this patient population. METHODS: This retrospective study evaluated the clinical characteristics, auxiliary examinations, and patient prognosis of HSE patients diagnosed with mNGS, and analyzed the prognosis of patients in both Glucocorticoid and Non-glucocorticoid groups. Assess the prognosis based on the improvement of GOS score and MMSE score at 1 and 3 months after discharge. RESULTS: A retrospective analysis was conducted in 29 hSE patients who met the criteria for GOS score improvement 3 months after discharge. The hormone group was better than the non-hormone group (2 (0-2) scores VS 1 (1-2) scores). There was no significant difference between the two groups in GOS score 1 month after discharge. However, no statistical difference was found in improving patient outcomes between the two groups. CONCLUSION: Despite the hormone group not obtaining the anticipated positive outcomes, potentially due to the relatively limited sample size in this study, previous case series reports have indicated that glucocorticoids, when used as an adjunct to acyclovir therapy, may enhance patient outcomes. Consequently, further extensive clinical studies involving multiple centers and larger sample sizes are warranted to investigate this matter further.