Currently, surgical obliterations are a mainstay for treating dural arteriovenous fistula (DAVF) in the anterior cranial fossa (ACF), which has high risks of hemorrhage and functional disorder. By introducing an endoscope into a high frontal approach (HFA) and utilizing its advantages, we attempted to establish it as a new surgical procedure that eliminates the drawbacks of various approaches that have been used to date. By using thirty clinical datasets of venous-phase head CT angiogram, measurements and comparisons on a 3D workstation were performed to identify the appropriate positioning of keyhole craniotomy for endoscope-controlled HFA (EHFA). Based on these data, a cadaver-based surgery was simulated to verify the feasibility of EHFA and develop an efficient procedure. In EHFA, though raising the position of the keyhole craniotomy made the operative field deeper, significant advantages were obtained in the angle between the operative axis and the medial anterior cranial base and the amount of bone removal required at the anterior edge of craniotomy. Minimally invasive EHFA, performed through a key-hole craniotomy without opening the frontal sinus, proved to be feasible on ten sides of five cadaver heads. Moreover, three patients with DAVF in ACF were successfully treated by clipping the fistula via EHFA. EHFA, which provided a direct corridor to medial ACF at the level of the foramen caecum and crista galli, and the minimum necessary operative field, was found to be a suitable procedure for clipping the fistula of DAVF in ACF.