MRI guided blood patch/fibrin injection (BFP) instead of CT BFP as treatment option for SIH, first case reported. Avoids radiation exposure, helpful for adolescents and women in reproductive age. Obviates CT myelography, decreasing risks, time, and making it available for patients with iodine allergy. Our case is a 26 yo female with SIH. Axial PD, Axial and Sagittal T2 HASTE were used for localization of dural ectasia. T2 HASTE MRI fluoroscopy was used for spinal needle placement at the T12-L1 epidural space and injection of 10cc autologous blood and 2 cc of fibrin. The result was improvement of symptoms.