Patients with ventriculo-peritoneal shunt (VPS) for hydrocephalus had an improved survival and are more encountered in need of abdominal surgery. Laparoscopic surgery has been reported safe for these patients, although infrequently. At least 3 types of complications had been recorded: shunt obstruction, infection, and vaginal migration. We report a case of middle-aged female with endometrial hyperplasia and VPS who has done laparoscopic hysterectomy safely. The authors encourage laparoscopic surgery in this subset of patients when indicated with some precautions, including minimal insufflation pressure, CO2 monitoring, minimal Trendelenburg, and vaginal stump closure.