Idiopathic intracranial hypertension (IIH) is an increasingly well-understood condition affecting patients’ vision but also their quality of life, because of debilitating headaches, tinnitus, and repercussion on their cognition [[1], [2], [3]]. While weight loss and acetazolamide remain first-line treatments [4,5], surgery has become increasingly critical to current management [6]. To date, there are no guidelines regarding indications for an invasive procedure, but usually they are considered in case of failure of first-line treatment (considered as a persistence of papilledema after dietary measures and the initiation of optimal medical treatment.), medication intolerance, or relapse upon discontinuation of acetazolamide leading to drug-resistance [7]. Surgery might also be considered in patients planning a pregnancy, as acetazolamide has not been proven safe during the first trimester, and weight gain could worsen visual outcomes [8]. Historically, options included optic nerve sheath fenestration and placement of lumbo-peritoneal, ventriculo-peritoneal or ventriculo-arterial shunts [9]. The use of shunts has proven more effective and has become the standard treatment, optic nerve fenestration remaining a second option in case of failure [[10], [11], [12]]. However, most published studies on this subject are dated [7]. More recently, endovascular stenting has been used in IIH patients with venous sinus stenosis. The first publications on this technique showed encouraging results [13], resulting in a growing trend towards using this technique, despite the absence of controlled trials [14]. Recent advancements in the technique of both procedures have allowed decrease in the number of their complications. To this day, there is limited number of data allowing comparison of these two procedures and patients are often undergo one procedure over the other based on their local surgeon’s or department’s specialization. A very recent large database study provides very valuable information [15] on the topic but smaller monocentric studies, with more homogeneous patients remains of interest. The objective of this study is to compare endovascular treatment with surgical treatment in patients suffering from IIH and presenting with papilledema.