Background: This study aimed to identify risk factors for postoperative cerebrospinal fluid (CSF) leaks and assess their outcomes following endoscopic endonasal approach (EEA) for resection of skull base tumors. Methods: A retrospective review was conducted of patients who underwent EEA for resection of intradural pathology between October 2001 and October 2023. Data on demographics, approach type, reconstruction technique, tumor pathology, complications and outcomes were analyzed. Results: A total of 542 patients were included, with 80.1% undergoing surgery for sellar or suprasellar pathology. Lumbar drains were used in 14.9%, and dural sealants in 57.7%. Forty patients (7.3%) developed postoperative CSF leaks, with the highest rate in sellar or suprasellar lesions (5.9%). CSF leaks were associated with longer hospital stays (p < 0.001), higher 30-day readmission rates (p < 0.001), increased sepsis risk (p = 0.021), and higher rates of diabetes insipidus (p < 0.001). Lumbar drains increased the incidence of CSF leaks (p = 0.021), while nasoseptal flap reconstruction reduced leak rates (p = 0.0015). Higher BMI and intraoperative CSF leaks were also significant risk factors (p = 0.001) Conclusions: CSF leaks are associated with increased complications and extended hospital stays, highlighting the need for vigilant intraoperative monitoring and targeted strategies.