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Dural arteriovenous fistulas (DAVF) are frequent causes of pulsatile tinnitus. Color Doppler sonography may play a useful, complementary role to CTA/MRA and digital subtraction angiography (DSA) in the assessment of these anomalies’ characteristics, such as an ipsilateral increased flow volume and a low resistive index. In this article, we report a case of DAVF first detected with Color Doppler sonography that displayed an uncharacteristic venous drainage pattern.