Cerebral venous and sinus thrombosis (CVST) is a rare but life-threatening disease accounting for less than 1% of all strokes and a poor outcome in around 10% of all patients. Early diagnosis is crucial because anticoagulation may reduce the risk of a fatal outcome and severe disability. However, the absence of specific features and the possibility of presentation without associated neurological signs can make its early recognition difficult. For these CVST patients with deteriorating symptoms, endovascular thrombolysis might give better outcome. We describe our five cases of CVST with clinical deteriorating symptoms treated with endovascular thrombolysis. Four patients made an excellent recovery, whereas one patient died despite maximal treatment including decompressive craniectomy.