Objective To evaluate the efficiency of regional cerebral oxygen saturation in the evaluation of consciousness recovery during emergence from general anesthesia. Methods A total of 110 adult patients who were scheduled for surgery under general anesthesia were selected. Near infrared spectroscopy (NIRS) was used to monitor the changes of regional cerebral oxygen saturation (rSO2). Mean arterial pressure (MAP), heart rate (HR), end‑tidal carbon dioxide partial pressure (PETCO2), SpO2 and rSO2 (rSO2‑L, rSO2‑R) on both sides of the patient at different time points (at baseline, before first response, at first reponse and during consciousness recovery) were recorded. Calculate and compare ΔrSO2‑L, ΔrSO2‑R, ΔMAP, ΔHR (ΔrSO2‑L, ΔrSO2‑R, ΔMAP, ΔHR is the difference value between the time point of rSO2‑L, rSO2‑R, MAP, heart rate and baseline value) corresponding to the change of consciousness prediction probability (Pk). Results During the first response, rSO2‑L, rSO2‑R, heart rate, and MAP increased compared with baseline. The Pk values of rSO2‑L, rSO2‑R, heart rate, and MAP from no response to the first reaction on stimulation were 0.973, 0.949, 0.844, and 0.667, respectively. Of the 110 patients, 94 patients showed orientation recovery when the first reaction occurred, while the other 16 patients consciously recovered later after the first response. For these 16 patients with delayed recovery, their rSO2‑L and rSO2‑R increased after recovery of consciousness compared with those at the first response (P<0.05). The Pk values of rSO2‑L and rSO2‑R in predicting consciousness recovery were 0.729 and 0.718, respectively. Conclusions Regional cerebral oxygen saturation can effectively evaluate the changes of consciousness in patients during emergence from general anesthesia.