Cranial defect can occur after trauma or tumor resection, subsequently leading to CSF leakage. When there is CSF leakage with a subtle dural tear or small defect, it can be managed by observation or endoscopic treatment. However, if the defect is large, it should be reconstructed by a regional flap or free flap. Temporalis muscle flap is favorable for reconstruction of a large defect due to its sufficient volume and reliable blood suply.In addition, by using the reverse temporalis muscle, extension to the anterior cranial base is possible, which is useful for CSF leakage due to cranial defect. We report a case using temporalis muscle flap and a case using reverse temporalis muscle flap with a review of literature.