While the dorsal epidural blood patch is frequently used technique for spontaneous intracranial hypotension due to dural CSF leaks, it may be less effective for ventral leaks. We report the technique of placing a CT-guided ventral transforaminal thoracic blood patch for a ventral thoracic CSF leak. A ventral transforaminal approach with CT guidance has not been reported, to our knowledge. In the appropriately selected patient, this targeted approach may be safely used.