Idiopathic hypertrophic cranial pachymeningitis is a rare inflammatory disease with diffused involvement of the dura. Often, the definite diagnosis is made immediately with biopsy and the involved dura is removed surgically. Consequently, extensive preoperative imaging studies usually are not available. We reviewed a case of idiopathic hypertrophic cranial pachymeningitis and collectively summarized the interesting features from the 7 years preceding surgical treatment. These chronologic imaging findings with progressive intracranial involvement included dural thickening, dural mass, sinus thrombosis, and venous congestion constituted comprehensive pictures of idiopathic hypertrophic cranial pachymeningitis. The thickened dura may also at times mimic dural masses, such as en plaque meningioma.