Hydrocephalus is a state of enlargement of the lumen caused by abnormal retention of large amounts of cerebrospinal fluid in the ventricular system or subarachnoid brain, and the posterior group of symptoms. Hydrocephalus caused by congenital diseases or malformations of the cranial spine is called “congenital hydrocephalus”, while those caused by acquired diseases are called “acquired hydrocephalus”. The pathological change of hydrocephalus is the gradual enlargement of the ventricular system. Under normal conditions, the secretion and absorption of cerebrospinal fluid are in a dynamic balance. In pathological conditions, however, excessive intracranial cerebrospinal fluid accumulates in the ventricular system or in the subarachnoid space. Hydrocephalus is clinically divided into two categories: obstructive hydrocephalus and transmissible hydrocephalus. Obstructive hydrocephalus is seen when the cerebrospinal fluid pathway is obstructed and the ventricular system is enlarged above the obstruction without dilatation of the subarachnoid space. It is mostly seen in congenital malformations, such as malformation of the midbrain aqueduct, which is the main cause of hydrocephalus in infants. At birth, there is often a large skull, followed by progressive abnormal enlargement of the skull, disproportionate head and body, mental retardation, and even spastic paralysis. Secondly, tumors directly block or compress the channels of the ventricular system leading to hydrocephalus. Traffic hydrocephalus is mostly caused by acquired lesions, such as meningitis and subarachnoid hemorrhage blocking the arachnoid granules, causing cerebrospinal fluid absorption dysfunction and dilatation of the ventricular system and subarachnoid space. There are also more treatment options for hydrocephalus, which just goes to show that no one method is yet completely satisfactory. Surgical treatment remains the mainstay, with the most commonly used procedures including the classic ventriculo-abdominal shunt and, in recent years, the more widely used neuroendoscopic approach. Ventriculoperitoneal shunts have been the main treatment for hydrocephalus since the middle of the last century. This procedure is well established and has a proven efficacy. However, although many improvements have been made to the shunt and the procedure can be combined with neuroendoscopy and laparoscopy, the procedure still has complications that are difficult to overcome, mainly obstruction of the shunt device, infection, excessive or insufficient shunting, and recurrence. In addition, the foreign body is left in the body for life, especially for young children, who will face the problem of tube replacement after growth. Neuroendoscopic treatment of hydrocephalus has a history of 100 years, but it has been developed and matured in the last decade or so with the update of endoscopic equipment, and has been used more widely. The effect of neuroendoscopic fistulas and intracranial pneumothorax are less common, which can demonstrate the superiority of minimally invasive, direct vision and deep operation. However, its indications are limited, and it is theoretically contraindicated for traffic hydrocephalus with impaired absorption of arachnoid granules. Inflammation, intracranial hemorrhage and obstructive hydrocephalus caused by brain radiotherapy may have arachnoid adhesions causing surgical difficulties or poor results. In fact, hydrocephalus is a seemingly simple but actually very complex disease, the surgical difficulty are not too difficult, but the ventriculoperitoneal shunt complications are more and difficult to overcome, neuroendoscopic hyaline septal fistula, three ventricular floor – interpeduncular pool fistula indications are still narrow. Therefore, I think that for the treatment of hydrocephalus, we should master various surgical techniques for hydrocephalus treatment, strictly grasp the indications for various surgeries, analyze them according to the specific conditions of different patients, and choose the best surgical plan. Patients who are suitable for neuroendoscopic surgery can first choose neuroendoscopic surgery, and patients who are expected to have poor results from neuroendoscopic surgery can choose classical ventriculoperitoneal shunt. For cases where the postoperative effect of a certain surgery is not satisfactory, another method can be considered when the conditions are suitable.