In this case report, we present a patient with Type B dural carotid-cavernous fistula (CCF), who had failed cannulation via the transfemoral route and subsequently underwent CCF occlusion via the anterior orbital approach through the superior ophthalmic vein (SOV). Successful occlusion of CCF was achieved, with excellent visual and cosmetic outcomes postoperatively. When all venous routes have been exhausted, the SOV approach is an excellent and viable alternative in the treatment of dural CCFs. Close cooperation between the orbital and neuro-interventional teams in a hybrid operating theatre setting is essential in ensuring success of the operation.