Hydrocephalus is a common neurosurgical condition, mostly in pediatric patients, and in adults it is mostly acquired. For example, trauma, encephalitis, etc. For a long time, the surgical treatment of hydrocephalus is mainly by shunt surgery. Compared with other shunts, ventriculo-peritoneal shunt has exact efficacy and is suitable for both traffic and non-traffic hydrocephalus, and has become the main treatment method for hydrocephalus, but its complications are more and limit the further application. Shunt obstruction is the most important cause of shunt failure and is difficult to avoid, due to the presence of small lateral holes at the ventricular and ventral ends of the shunt, the presence of rate-limiting valves, filters, and connectors, and the ease of blockage, as well as the presence of more jelly-like or yellow-brown spotty deposits and flocculent secretions in the ventricles during endoscopic surgery for traumatic, hemorrhagic, and infected hydrocephalus, which may be the main cause of shunt obstruction . Postoperative infection is another major cause of shunt failure, which can occur intracranially, in the abdominal cavity and in subcutaneous tunnels. Although there have been continuous improvements in shunt material and function, and improvements have been made to the shunt side holes, adjustment valves, and catheter materials, the results are not ideal, and foreign bodies are left in the patient’s body for life, and young children may face the pain of multiple tube changes as their bodies grow taller; the siphoning effect of the shunt causes excessive cerebrospinal fluid shunting and low cranial pressure, leading to postoperative subdural hematoma and subdural fluid; because the shunt can be palpable under the skin The shunts can be palpable or even visible, which has a certain degree of psychological impact on young patients, and skin surface allergy and rupture can also be reported. Neuroendoscopic techniques began in the early 20th century, but were not further developed due to the rudimentary surgical instruments, high mortality rate, and poor outcomes at that time. In recent years, with the development of neuroimaging, optical techniques, microsurgical instruments, and stereotactic neurological systems, the indications for neuroendoscopic tricortical ventriculostomy (ETV) have been broadened and regained an increasing role in the field of non-traffic hydrocephalus. Beginning in the 1990s, endoscopy began to change the way neurosurgery was performed, becoming an important tool in microinvasive neurosurgery, and hydrocephalus is the best indication for neuroendoscopic treatment. etv is the preferred approach for hydrocephalus and has certain advantages. It has incomparable advantages over ventriculoperitoneal shunts, including: first, it is more in line with the normal circulatory and physiological state of cerebrospinal fluid, effectively maintaining normal intracranial pressure and physiological circulation of cerebrospinal fluid; second, there is no shunt tube or other foreign body implanted, avoiding intracranial or abdominal infections caused by the shunt device, and thus avoiding shunt failure due to shunt blockage; third, the flow of cerebrospinal fluid Third, the speed of cerebrospinal fluid flow is uniform, and there is no fluctuation of the shunt speed due to shunt siphoning with the change of body position, which will not lead to excessive drainage of cerebrospinal fluid and avoid the occurrence of subdural hematoma and subdural effusion; fourth, it is not affected by the growth and development of children and avoids the pain of multiple tube changes; fifth, the operation is relatively simple and the operation time is shorter; sixth, there is no risk of arachnoid fistula that may be caused by the traditional transendocardial third ventriculostomy. Sixth, it does not cause the failure of surgery due to subarachnoid atresia that may be caused by traditional transendogenic third ventriculostomy. It is an effective method for the treatment of obstructive hydrocephalus and is in line with the modern concept of minimally invasive neurosurgery. The procedure is performed under direct vision and allows cerebrospinal fluid to enter the physiological circulation through the fistula in a short time, avoiding various complications of shunts, and is simpler and more reliable than VP shunts, which is worthy of further clinical promotion.