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Post-dural puncture headache is a well-known clinical complication of intrathecal space instrumentation. Various modalities have been proffered for treatment of PDPH, however epidural blood patch remains the gold-standard therapy. Notwithstanding its widespread usage, clinicians should not regard it as a benign procedure without complication. Judicious consideration should be applied to patient selection in addition to indication, timing and optimum technique to mitigate risk and improve outcomes.