Objective To explore the treatment strategy for mouth and nose bleeding caused by skull base fractures. Methods A retrospective analysis was done on 14 patients with severe skull base fracture combined with nose and mouth bleeding admitted to hospital. Tracheotomy or tracheal intubation was performed to ensure airway patency. When anti-shock was performed, the patients were sent for carotid artery angiography to identify the blood vessel. Then, hemostasis was done by means of direct intravascular interventional embolization. Results Timely and successful hemostasis was achieved in all 14 patients after embolization, with no complications occurred. Of all patients, there were 10 patients with good recovery, three with disability and one death. Severe disability and death were related to brain injury. Conclusions After maintenance of airway patency and effective blood pressure, emergency endovascular embolization can effectively improve the rate of successful treatment of nose and mouth bleeding caused by traumatic skull base fractures, especially for patients combined with traumatic brain injury.