The treatment of dural fistulas is varied and complex. Treatment decisions require consideration of the nature of the symptoms, the location of the lesion, the complexity of the angioarchitecture, and the risk of progression. Standard treatment modalities include compression therapy, endovascular embolization, neurosurgery, and radiosurgery. Complex lesions will often require multiple different interventions. Because dural fistulas may present with a variety of neurologic and ophthalmologic problems, a team of neurologists, neuro-ophthalmologists, neuroradiologists, and neurosurgeons should develop a comprehensive treatment plan.