OBJECTIVE To investigate the best approach of diagnosis and treatment of spontaneous cerebrospinal fluid rhinorrhea.METHODS The clinical data of 13 cases with spontaneous cerebrospinal fluid rhinorrhea performed in our hospital from 1998 to 2007 were analyzed retrospectively.RESULTS The diagnosis of spontaneous cerebrospinal fluid rhinorrhea was established for these 13 cases on a set of diagnostic program,including qualitative determination of sugar in the nasal leakage,nasal endoscopy, CT and MRI scan.All the patients were failed with conservative treatment.All of the 13 patients were cured by surgical repairing under nasal endoscope for follow up of 6 months to 6 years.CONCLUSION The diagnosis program for spontaneous cerebrospinal fluid rhinorrhea includes qualitative determination of sugar in the nasal leakage,nasal endoscopy,CT and MRI scan.Transnasal endoscopic management is the best method for repairing spontaneous cerebrospinal fluid rhinorrhea.