The fast-paced life makes people physically and mentally exhausted, and the prevalence of diseases inevitably increases people’s economic pressure and psychological burden. If left untreated, hydrocephalus can lead to impaired walking, urinary and fecal incontinence, mental decline and cognitive decline, so early detection, diagnosis and treatment are important. Most patients with hydrocephalus are treated mainly with surgery, while a few can be treated with medication or other treatments. Bypass is a classic procedure for hydrocephalus, however, many people are not very clear about this procedure and often have a lot of confusion. Does hydrocephalus surgery require a craniotomy? This is a question that patients are often eager to know. Here we can clearly tell patients that bypass surgery does not require craniotomy, so there is no need to worry too much about it. In clinical practice, shunts are subdivided into ventriculoperitoneal shunts, ventriculothoracic shunts, ventriculoatrial shunts, and shunts from the lumbar pool to the abdominal cavity. Here, we take ventriculoperitoneal shunt as an example to explain the specific operation principle, which is to insert a drainage tube at the ventricular end into the ventricle through a hole in the skull, connect the drainage tube to a shunt valve, and then connect the drainage tube at the abdominal end, and place the drainage tube into the abdominal cavity through a subcutaneous tunnel. In simple terms, a tube is used to shunt excess cerebrospinal fluid from the skull into the abdominal cavity to be absorbed, and the entire procedure is relatively simple and time-consuming. Ventriculothoracic and ventriculoatrial shunts operate on the same principle, except that the final site of absorption of cerebrospinal fluid is either the chest or the atrium, depending on the patient’s physical condition. While shunts do have some advantages in the treatment of hydrocephalus, their drawbacks (such as infection, blocked or broken shunts, etc.) should not be overlooked. Specialized techniques in cerebrospinal fluid department not only effectively treat all types of hydrocephalus, but also are able to avoid various postoperative complications.