Cerebrospinal fluid (CSF) leakage occurs very commonly as a consequence of severe head trauma in which the cranial vault or base of the skull is fractured. Although it has been estimated that they complicate 2 percent of all cases of head truma, the incidence of a persistent traumatic cerebrospinal fluid leak is certainly very low. CSF leakage from its intracranial location may present difficulties in diagnosis, localization, and treatment. Recently the otolaryngologist play a major role in the diagnosis and treatment of CSF otorrhea or rhinorrhea and are becoming increasingly involved in the operative management of CSF leakage. We have experienced a case of CSF otorhinorrhea with congenital cholesteatoma. A 35 year old woman suffered from CSF rhinorrhea and bacterial meningitis after head injury. This fistula localization was aided by tympanocentesis and computed tomography of the temporal bone. She has been asymptomatic for 10 months since removal of cholesteatoma via translabyrinthine approach and obliteration of the cavity.