Aim: The advances in endoscopic sinus surgery have made it the procedure of choice for treatment of cerebrospinal fluid (CSF) rhinorrhea. The objective of this study was to study the etiological factors, the outcome of transnasal endoscopic repair, and limitations of the technique. Materials and methods: Thirty-two cases of CSF rhinorrhea were evaluated. Patients underwent thorough clinicoradiological evaluation followed by transnasal endoscopic repair. Patients were followed up at monthly intervals. Results: Out of 32 cases, 14 were due to the head injury, 12 were spontaneous, two were iatrogenic, two congenital defects, one was a case of tubercular osteomyelitis and one was idiopathic. CSF leak was successfully plugged in 29 patients. In one patient, the procedure had to be converted to an extracranial external approach. Two patients underwent successful revision endoscopic procedure. One patient was lost to follow-up. Conclusion: Head injury remains the leading cause of CSF rhinorrhea. The spontaneous leak patients represent a distinct clinical group with a characteristic patient profile, clinical features, and radiology. The results of endoscopic repair are excellent, especially in nonspontaneous cases. We recommend it as the optimum surgical approach for both primary and revisional surgical management of CSF rhinorrhea.