Triventriculostomy is primarily indicated for obstructive hydrocephalus because there are two prerequisites for successful triventriculostomy: the patient has normal cerebrospinal fluid absorption; and the subarachnoid cerebrospinal fluid circulation is unobstructed, so the selection of patients with different etiologies of hydrocephalus has a direct impact on the outcome of the procedure. A successful triple ventriculostomy is one in which the patient’s symptoms improve, intracranial pressure decreases, and the ventricles have varying degrees of reduction without the need for further shunts. Overall: obstructive hydrocephalus can achieve a more satisfactory surgical success rate. The surgical success rate for obstructive hydrocephalus due to midbrain conduit stenosis, parietal and thalamic tumors, posterior cranial fossa tumors, pineal area tumors, cervical medullary spinal bulge, and cysts is 83%-95%. Therefore, obstructive hydrocephalus caused by any occupancy between the posterior half of the three ventricles and the exit of the four ventricles is the best indication for triculostomy. In pediatric patients with hydrocephalus, surgical success rates are lower in infants under 1 year of age (0%-23%), whereas surgical outcomes are better in pediatric patients over 2 years of age and are comparable to those of adults. Most authors believe that the surgical success rate is proportional to the age of the patient. Compared with extracranial shunts for hydrocephalus, the main advantages are as follows: (1) There is no foreign body implantation such as shunts in triculostomy, which can avoid intracranial or abdominal infections caused by shunting devices and consequent shunt blockage and shunt failure. (2) With tricorticostomy, the cerebrospinal fluid in the ventricles can flow directly into the interpeduncular pool and be absorbed into the subarachnoid space of the brain and spinal cord after surgery, thus conforming more to the normal physiological state of the cerebrospinal fluid circulation than extracranial cerebrospinal fluid shunts, which can effectively maintain the normal intracranial pressure balance and the physiological function of the cerebrospinal fluid. (3) The flow rate of cerebrospinal fluid in triculostomy is uniform, and there will be no fluctuation of the shunt rate with the change of body position due to shunt siphoning, and no excessive drainage of cerebrospinal fluid. (4) It is not affected by the growth and development of children, and avoids the pain of multiple tube replacement procedures. (5) The surgical operation is relatively simple and the operation time is short (generally about 40min). (6) Triple ventriculostomy can be used for patients with non-traffic hydrocephalus who have failed shunts or shunts with infected adhesions, and also obtain better results (success rate 76%-84%). For patients with multiple shunt blockages resulting in shunt failure, triculostomy is certainly an excellent alternative treatment.