Abstract Body: Objective To explore the diagnosis of cerebral venous sinus stenosis(CVSS) in idiopathic intracranial hypertension(IIH)，and to evaluate the efficacy and risk of venous sinus stenting treatment for CVSS．Methods 50 patients with refractory IIH complicated with CVSS underwent examination with magnetic resonance venography (MRV)，digital subtraction angiography(DSA) and direct retrograde cerebral venography and manometry to confirm morphologic features of IlH and measure venous pressure．The CSF pressure on lumbar puncture ranged from 250 to 500 mmH₂O with normal composition. All patients had headache, and funduscopic examination demonstrated papilledema for all patients. 38 patients who showed severe stenosis of venous sinuses with the pressure gradient across the stenosis >100 mmH₂O were treated with venous sinus stenting and were followed-up for more than 12 months．Intrasinus pressures were recorded before and after the procedure and correlated with clinical outcome during the follow-up period. Results Sinus stenting angioplasty was successful in all 38 patients．In all patients venous sinus stenosis was improved after stenting procedure (the residual stenosis rate<20％) and intrasinus pressure was reduced (the pressure gradient vanished or<20 mmH₂O )．The clinical symptoms in all the patients were improved or disappeared at discharge and intracranial pressures were normalized within 3 months after the procedure．During the follow-up period of (12.3±11) months (range 12 to 24 months)，no patient had recurrence of IIH．In all cases，DSA or MRV was performed at 12-month follow-up and demonstrated the absence of sinus thrombosis or in-stent stenosis. Conclusions Patients with refractory IIH should be assessed for CVSS．MRV or DSA was recommended for these patients as a routine work-up．Cerebral venography and manometry are helpful to evaluate the relation between venous outflow obstruction and intracranial hypertension．If severe CVSS is presented in patients who experienced medical treatment failure, endovascular stent placement could be an alternative to classic surgical approaches. Additional randomized and controlled clinical research is deserved.