Postdural puncture headache is the most common complication of unintentional dural puncture with an epidural needle. We present here the case of a 44-year-old woman who developed a severe headache from pneumocephalus, which was the result of an epidural blood patch procedure being performed to treat a PDPH. Both the epidural block and the autologous blood patch procedure were done at the L4-5 interspinous space with the loss of resistance technique and using air. After the epidural blood patch procedure, the headache was not relieved at the supine position and the computerized tomographic brain scan revealed the presence of air within the intracranial cavities. After conservative treatment, she was discharged from the hospital on the fourth-day without any neurologic sequelae.