Posterior fossa dural arteriovenous fistulae (DAVF) are uncommon lesions. In the past, treatment of these lesions has involved both surgical and endovascular techniques, the latter being favoured in contemporary neurovascular medicine. We describe our experience in the case of a 71-year-old woman with a posterior fossa DAVF who presented with sudden onset headache, collapse and neurological deficit secondary to a subarachnoid haemorrhage. She was treated by means of direct surgical access of the lesion combined with endovascular occlusion resulting in a radiological and clinical cure.