Hydrocephalus is a pathologic dilatation of the ventricles which occurs progressively when provoked by a disruption in the production, circulation and reabsorption of the cerebrospinal fluid (CSF). This study aims to report the impact of co-morbidities on the surgical outcome of pediatric hydrocephalus in Guinea. It was a retrospective clinical study carried out at Friendship hospital, Sino-Guinea of Kipe, for 13 months. 107 patients were scheduled for hydrocephalus surgery. The incidence of Hydrocephalus was 8.20% related to the 107 patients admitted during our period of study. The main comorbitdies encounter were, anemia (73 cases), respiratory infection (38 cases) malaria (malaria 37 cases), malnutrition (14 cases), deshydratation (11 cases), candidosis (7 cases), respiratory detress (6 cases), cutaneous infections (6 cases), convulsion (6 cases), meningitis (5 cases), otorhinolaryngology infection (2 cases), septicemia (2 cases) tardive neonatal infection (91 cases). The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. Hydrocephalus is a commonly encountered pediatric pathology in sub-Saharan Africa where it constitutes a major public health concern. The etiologies are still dominated by neonatal infections. The treatment is essentially a surgical approach.