Hydrocephalus is a common disease in pediatric neurosurgery, which seriously affects children’s health and requires early diagnosis and treatment. The main manifestations are rapid head growth beyond normal values for the same age; vomiting, irritability, crying, and double downward vision. In infants, their head circumference development should be routinely tested and compared with reference values. Hydrocephalus is a neurosurgical condition and requires surgical treatment. There are three types of surgical procedures: 1. evacuation surgery: interventricular foraminoplasty, aqueductoplasty, fistulotomy of the outflow tract of the four ventricles, etc. 2, bypass surgery: third ventricular floor fistula, hyaline septal fistula, etc. 3.Bypass surgery: ventriculoperitoneal shunt, ventriculoatrial shunt, etc. Theoretically, evacuation surgery and bypass surgery should be preferred because they are more in line with human anatomy and physiology. If evacuation surgery and bypass surgery are ineffective, then bypass surgery should be chosen. Ventriculoperitoneal shunts have been performed for nearly 70 years and are currently the most common surgical procedure used to treat hydrocephalus in children. The shunt shunts the increased intracranial cerebrospinal fluid directly into the abdominal cavity, with significant surgical results. However, it requires a lifelong tube with shunt obstruction, fracture, and infection, which will require another or multiple shunt revisions in the future. Recently, endoscopic third ventriculostomy is gaining attention as a bypass procedure, which is more physiological than shunt surgery. Endoscopic third ventriculostomy is minimally invasive, does not require a lifelong tube, and is an important procedure in the treatment of hydrocephalus in children. After endoscopic third ventriculostomy, cerebrospinal fluid from the third ventricle crosses the obstruction site through the fistula and is absorbed directly into the subarachnoid space without the need for placement of a shunt. Minimally invasive treatment of hydrocephalus is achieved. In children for whom a triventriculostomy is ineffective or unsuitable, a ventriculoperitoneal shunt is then considered.