An unusual case of cerebrospinal fluid otorrhea following mastoidectomy has been encountered by us. We shall review some pertinent concepts about this problem and discuss the surgical management of this condition. The case under discussion by no means embodies a new or exceedingly rare problem. However, very few, if any, of the similar cases reported in the literature contain all of the following features: (1) a history of repeated operations on the mastoid bone; (2) intermittent cerebrospinal fluid discharge from the ear over a 12-year period; (3) recurrent bouts of meningitis; (4) the presence of a pulsating herniation of meninges into the external auditory canal; (5) utilization of a button of bone to repair a defect in the temporal bone; (6) cessation of otorrhea and return to normal activity. Indeed, the majority of cases of cerebrospinal fluid otorrhea are of traumatic origin and frequently heal spontaneously. It cannot be overemphasized