Serum Homocysteine elevation, has been observed in some cerebral vinous sinus thrombosis patients. There is a complex overlap between homocysteine level and cerebrovascular disease, and the cause and significance of homocysteine rise in cerebral vinous sinus thrombosis are still controversial.To detect serum homocysteine level in patients with cerebral venous sinus thrombosis and its impact on its severity, short term outcome, size of thrombosis. In this case control study, sixteen patients of CVST (13 males & 3 females) and 35 matched control subjects were recruited for this study. Serum homocysteine level was estimated by Enzyme-Linked Immunosorbent Assay (ELISA). Assessment of severity of thrombosis was done based on Canadian Neurological Scale. Assessment of outcome on discharge was done based on Barthel index score. In this study serum homocysteine level was raised in Cerebral Vinous Sinus Thrombosis cases when compared to controls on admission. The mean and standard deviation of homocysteine were 42.5 ± 54.2μmol/l in cases with significant p value of < 0.05. Cases with high homocysteine levels had low severity scores, which indicate poor prognosis. Homocyteine elevation in cerebral vinous sinus thrombosis (CVST) patients was associated with CT changes, severe thrombosis, large thrombus size and bad outcome.