Intracranial nail injuries to the brain are rare. Various techniques for the removal of penetrating nails have been reported, but to date successful nail extraction following an injury involving the superior sagittal sinus (SSS) has not been reported. The authors report the case of a nail-gun injury to the midline parietal region with penetration of the SSS. They describe an original surgical technique involving the use of a graft patch of temporal fascia and muscle to repair the SSS following extraction of the nail. The procedure resulted in preservation of distal flow across the sinus and a good neurological outcome. Technical considerations in the repair of penetrating posterior SSS injuries are discussed. Penetrating nail injuries to the brain involving the SSS can be successfully repaired with maintenance of sinus patency.