We report a case of dural arteriovenous fistulae in the posterior fossa successfully treated by transvenous direct embolization. This 55-year-old male presented with repeated episodes of alexia, followed by pulsatile tinnitus and headache in December 1992. Cerebral angiography revealed a dural arteriovenous fistulae at the left sigmoid sinus fed by tiny branches of occipital artery. The fistulae drains through the vein of Labbé and internal cerebral vein, into the cavernous sinus and superior sagittal sinus. The proximal and distal part of the sigmoid sinus was occluded. First we tried to obliterate the fistulae by transarterial embolization with PVA particles, which reduced shunting flow and ameliorated the symptoms immediately. The symptoms, however, recurred one week after the treatment because of the recruitment of dural collateral vessels. Next we selected transvenous direct embolization under small retro-mastoid craniectomy. Thirteen stainless steel coils were placed in the affected sinus, and abnormal vascular network disappeared completely without occluding normal venous pathways. The patient remains symptom-free, and the repeated cerebral angiograms performed six months after the second treatment demonstrated no definitive abnormality. From our experience and review of the literature, transvenous embolization appears to be the less invasive and more curative treatment of arteriovenous fistulae in the posterior fossa.