Background: This is a prospective, single-blinded observational study examined the frequency and severity of postdural puncture headache in the Egyptian female patients following spinal anesthesia for cesarean section. Method: All the females scheduled for cesarean section under spinal anesthesia in Cairo university were included and divided into two groups, one with Quinke needle G22 and one with Quinke needle G20, both groups were followed up for 7 days regarding incidence and severity of PDPH. Result: The overall incidence of postdural puncture headache was 32.58% in group with Quinke needle G22, while it was 32.86% with the group used Quinke needle G20, PDPH almost relived by the fifth day in both groups, patients rated their headache as mild to moderate on a 10-cm visual analog scale. Conclusions: This study is a documentation of the Cairo University teaching hospital experience with PDPH in female patient undergoes spinal anesthesia, and it focus on the incidence and severity related to the needle size and Egyptian population. We recommend the usage * Corresponding author. Address