The occurrence of a postdural puncture headache (PDPH) is a known risk associated with epidural procedures. The primary nonconservative treatment option for PDPH is the performance of an epidural blood patch. This case report describes the use of image guidance for placement of a caudal epidural to treat a PDPH in a postpartum patient. A caudal catheter was placed under real-time guidance and visualization of the deposition of the blood was obtained. By entering via the caudal foramen and utilizing a catheter, manipulations in catheter placement could be performed to adjust deposition of the blood.