Frontal sinus Cerebrospinal Fluid (CSF) leak is relatively uncommon. Surgical treatment is indicated when conservative management fails. Here we present a case report of 19-year-old male who presented with delayed CSF rhinorrhea after trauma with one episode of meningitis. On evaluation, frontal sinus posterior vault leak was seen. The repair was done by osteoplastic flap raising approach. Follow-up clinico-radiological assessment showed no evidence of leak or defect. Although endoscopic approach is used most commonly now-a-days, defect in posterior vault may not be adequately dealt especially if defect is laterally or superiorly located as seen in this case. This case is reported to highlight the indication of open approach in endoscopic era.
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