Background: Localizing and repairing CSF leaks needs robust radiological work up. HRCT & CT Cisternography are the routinely used investigations, sometimes complimented with heavily T2W MRI in localizing the bony / dural defects. The sensitivity and specificity of HRCT, CT Cisternography and MRI needs further validation. Aims & objectives: To evaluate the utility of HRCT, CT Cisternography and MRI, individually and in combination, in localizing CSF fistula and compare the results with intra-operative findings. Materials and Methods: Retrospective evaluation of radiological procedures of 40 patients with clinically suspected CSF rhinorrhea / otorrhea was carried out in JSS hospital, JSSAHER Mysore. HRCT was done in all 40 patients, while CT cisternography in 38 patients and MRI in only 18 patients. Endoscopic evaluation / repair were carried out on 38 patients and was used as gold standard for statistical analysis. Results: Among 40 patients evaluated for CSF leak by radiological imaging, total of 38 patients underwent surgical / endoscopic exploration. Most common presenting symptom was CSF rhinorrhoea with cribriform plate and lateral lamella showing maximum number of defects. Sensitivity and specificity of imaging techniques improved significantly when used in combination. Conclusion: HRCT of skull base is simple, fast, noninvasive and cost effective choice of examination in the workup of CSF leak. However when used in adjunct with CSF cisternography and heavily T2W MRI the accuracy improves significantly, justifying the additional efforts and cost.