Cerebral developmental venous anomalies are asymptomatic benign cerebrovascular malformations that are commonly found accidentally on brain magnetic resonance imaging. It is not uncommon for cerebrospinal fluid flow to be obstructed at the level of the aqueduct of Sylvius, causing an obstructive non-communicating hydrocephalus. Most notable reasons for such an obstruction at that level are tumors, congenital etiology, or post-inflammatory gliotic atresia. Herein we present the case of a 65-year-old male patient with an unusual symptomatic developmental venous anomalies causing stenosis and obstruction of the aqueduct of Sylvius at the level of the mesencephalon. Features of this case are discussed together with its implications, including recognizing, diagnosing, and treating such a finding.