It is probable that a significant number of cases of pseudotumor syndrome (PTS) occur because of cranial venous outflow obstruction, yet reports of direct treatment of the obstruction are few and inconclusive. In this study the authors report three cases of PTS with angiographically confirmed venous sinus obstruction treated by direct, endovascular procedures; urokinase infusion in two and balloon venoplasty in one. Two patients suffered transient complications that resolved satisfactorily. All three showed initial resolution of the signs and symptoms of PTS but one relapsed after 8 months and required surgical treatment. The possible role and methods of treatment of cranial venous outflow obstruction in PTS are discussed.