Locating spinal cerebrospinal fluid (CSF) leaks can be a diagnostic dilemma for clinicians and radiologists, as well as frustrating for patients. Dynamic computed tomography myelography (dCTM) has emerged as a valuable tool in localizing spinal CSF leaks, aiding in accurate diagnosis, and guiding appropriate management. This article aims to provide insights into the technique, tips, tricks, and potential pitfalls associated with dCTM for spinal CSF leak localization. By understanding the nuances of this procedure, clinicians can optimize the diagnostic process and improve patient outcomes.