Hydrocephalus is a condition in which the amount of intracranial cerebrospinal fluid increases due to cranio-cerebral disorders that cause excessive secretion or (and) impaired circulation and absorption, and enlargement of the ventricular system or subarachnoid space. Although 20% of untreated congenital hydrocephalus can stop progressing, about half of the children die within a year. Neurological deficits in patients with hydrocephalus are positively related to the severity of hydrocephalus and should be actively treated. For congenital hydrocephalus in children, surgical treatment is the first option as of now. Surgery for hydrocephalus in infants and children should be done from the least invasive procedure. The key to surgery is to choose the procedure according to the etiology of hydrocephalus. For hydrocephalus formed by stenosis of the middle cerebral aqueduct or arachnoid cyst, it is recommended to first use soft neuro-electroventricular endoscopy, to perform dilation of the middle cerebral aqueduct stenosis or stenting of the middle cerebral aqueduct under soft neuro-electroventricular endoscopy to clear the middle cerebral aqueduct to solve the hydrocephalus problem, or to perform third ventriculostomy or arachnoid cyst ventriculoscopic windowing and internal drainage. For children with traffic hydrocephalus or those for whom ventriculoscopic internal drainage is not effective, ventriculoperitoneal shunts are the only way to relieve hydrocephalus. Sometimes the hydrocephalus is so severe that the parenchymal part of the brain is very thin at the time of the child’s visit. At this time, the risk of doing a normal shunt is quite high, which can easily cause intracranial hemorrhage and disability, or even death. Therefore, it is necessary to apply the adjustable pressure shunt system for surgery to avoid postoperative complications. After early treatment of hydrocephalus, the neurological function of the child will gradually recover. As long as the treatment is timely, most children recover well and can achieve the same intellectual and growth development as normal children. In contrast, external hydrocephalus, also known as secondary hydrocephalus, develops at the age of 1 to 1.5 years before the closure of fontanelle, mostly in infants around 6 months of age, and is often seen as an increase in head circumference, with some children having convulsive episodes and high and bulging fontanelle tension. The closure of fontanelle is delayed, although the head is large and there is no hydrocephalus, and there is no sunset sign in the eyes. The development and governance of the child are mostly normal. To confirm the diagnosis of external hydrocephalus, laboratory tests and other ancillary tests are generally required. Laboratory tests mainly check for abnormalities in the primary EH. Secondary EH is the primary cause of different laboratory test results, such as vitamin A deficiency, anemia, etc. Ancillary examinations are mainly CT examinations. The children show insignificant ventricular enlargement, widening of the base pool, fissure, longitudinal fissure pool and cerebral hemispheric sulcus, and enlargement of the subarachnoid space. External hydrocephalus is a benign self-limiting disease and most children do not require any surgical treatment and can be expected to resolve on their own. Mild cases of external hydrocephalus may resolve spontaneously, while those with primary disease should be treated aggressively. For those with increased intracranial pressure, carbonic anhydrase inhibitors, such as acetazolamide or acetamide, or dehydrating agents, such as mannitol, can be used to reduce cranial pressure. Currently, the medical community does not advocate the use of fontanelle puncture to release fluid or cerebrospinal fluid shunts. If there are frequent convulsions, anti-epileptic drugs can be given for a short period of time, and in severe cases, ventral drainage of extracerebral fluid is feasible.