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Objectives: Surgical treatment is the preferred treatment for pediatric hydrocephalus. The analysis of the outcome of pediatric hydrocephalus surgery and its complications is limited by the lack of available data. Our goal was to better understand the effectiveness of surgery and to explore better surgical treatment methods and management of complications.Methods: 163 patients with pediatric hydrocephalus were included. A retrospective chart review was performed on all patients. Data collected included surgical techniques, number of surgical treatments, complications, and basic demographics.Results: There were 163 patients in this group including 103 males and 60 females. Among the patients, 106 (106/163, 65.0%) patients received ventricular peritoneal shunt (VP), 7 (7/163, 4.3%) patients received ventricle-right atrium shunt (VA) and 50 (50/163, 30.7%) patients received endoscopic third ventriculostomy (ETV). Among the patients who received VP, 74 (74/163, 45.4%) patients were cured and 32 (32/163, 19.6%) patients underwent surgery again. Among the patients who received VA, 38 (38/163, 23.3%) patients were cured and 12 (12/163, 7.4%) patients underwent surgery again. Among the patients who received ETV, 3 (3/163, 1.8%) patients were cured and 4 (4/163, 2.5%) patients underwent surgery again. The most common complication is shunt-related peritonitis or abdominal abscess, abdominal end obstruction (17/163，10.4%).Conclusion: A single surgery can cure most patients, and sometimes more than one surgery is required. For pediatric hydrocephalus, ETV is more efficient and has fewer surgical complications. However, the management of unrelieved symptoms and related complications after ETV surgery and bypass surgery should still be taken seriously.