Recent reports have suggested that the transnasal endoscopic approach to anterior skull base meningoencephalocoeles has now become the treatment of choice (S.J. Kanowitz, J.M. Bernstein, Pediatric meningoencephalcoeles and nasal obstruction; a case for endoscopic repair, IJPO 70 (2006) 2087–2092; B.A. Woodworth, R.J. Schlosser, R.A. Faust, et al., Evolutions in the management of congenital intranasal skull base defects, Arch. Otolayngol. Head Neck Surg. 130 (2004) 1283–1288; B. Woodworth, R.J. Schlosser, Endoscopic repair of a congenital intranasal encephalocele in a 23 months old infant, Int. J. Pediatr. Otorhinolaryngol. 69 (2005) 125–131; R. Rahbar, V.A. Resto, C.D. Robson, et al., Nasal glioma and encephalocele: diagnosis and management, Laryngoscope 113 (2003) 2069–2077; T. Van Den Abbeele, M. Elmaleh, P. Herman, M. Francois, P. Narcy, Transnasal endoscopic repair of congenital defects of the skull base in children, Arch. Otolaryngol. Head Neck Surg. 125 (5) (1999) 2087–2092). This approach has the advantage of allowing complete excision and repair of the skull base without the risks of frontal lobe retract ion and with a very low risk of CSF leak. This approach has been used successfully in children as young as 15-months. We report a successful endoscopic excision and repair of a nasal meningoencephalocoele in a 6-month-old infant in order to demonstrate that this approach is safe and efficacious even in very young children.