This report describes the use of a single shot, through the needle caudal approach to epidural blood patch (EBP) in a patient with persistent leakage of cerebrospinal fluid following lumbosacral laminectomy. A previous report of caudal EBP in an adult patient with an epidural catheter suggested that the success of the procedure could be comparable without the use of a catheter. This case report documents the success of through the needle caudal EBP in an adult patient.