A 14-year-old boy who suffered from cerebrospinal fluid (CSF) rhinorrhea and repeated meningitis treated in other hospitals. Previous computed tomography(CT) and magnetic resonance imaging(MRI) revealed a suspicious cholesterol granuloma located in right petrous apex. As the CSF rhinorrhea aggravated recently and the pathological location was not certained, the patient was transferred to our hospital for further management. Dynamic CT cisternography showed a fistula extending from a focal bony defect of the right petrous tip and right Meckel's cave via the foramen lacerum to the right nasopharynx. The fistula was surgically repaired and the patient was discharged smoothly without recurrent symptoms.