Intracranial hypotension due to cerebrospinal fluid (CSF) leakage is characterized by orthostatic headache that worsens in upright position and is relieved by recumbent position. Spinal surgeries may cause iatrogenic CSF leaks and presents clinical manifestations of intracranial hypotension. We report a patient who presented orthostatic headache due to intracranial hypotension after posterior mediastinal mass excision.