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Postdural puncture headache is a well- known complication of spinal anesthesia, but the subsequent development of intracranial subdural hematoma is a serious life–threatening complication which should be urgently treated. We present the case of a 32-year-old pregnant woman who was scheduled for cesarean section. Spinal anesthesia was induced using a 25-gauge Quincke spinal needle. After 48 hours she developed postdural puncture headache which was treated conservatively and she was discharged home. On the 30th day post operatively, the patient developed intracranial subdural hematoma which was surgically evacuated in the operating room and the patient had full recovery. Our report reviews the literature on 49 patients who developed a postdural puncture headache complicated by intracranial subdural hematoma following spinal anesthesia. Careful follow up and good communication between the anesthesiologist, the obstetrician and the neurosurgeon is essential for early diagnosis and management of possible subdural hematoma for patients developing a postdural puncture headache.