Background: Treatment for hydrocephalus often involves the installation of a ventriculoperitoneal (VP) shunt. Relatively uncommon problems include migration and extrusion of the VP shunt's distal end. Once the distal end of the VP shunt extruded to the external environment or imbedded in unclean media the risk of CNS infection associated with morbidity and mortality will increase. Periodic follow for the VP shunt and early management of the complications is a goal to all neurosurgeons nowadays.   Objectives: to outline the serious rare complications of the ventriculoperitoneal shunt that may happen due to ignorance of the periodic follow up, and the value of early intervention to decrease the morbidity and mortality of these cases. . Patient and methods: A retrospective study conducted at Sohag University Hospitals on twelve hydrocephalic patients treated with ventriculoperitoneal shunt, during the period from April 2021 to January 2024. Under general anesthesia, our patients treated with VP shunt extraction then a new shunt applied or revision of the same distal tube of the VP shunt. Results: We included twelve patients with median age 12.5 months and male to female ratio (3:1) manifested by ventriculoperitoneal shunt complication: extrusion through the anus ( 4 cases 33.3%), scrotum (two patients 16.7%) other sites( 6 patients 50%) like: coiling of the distal end around the flusher, migration to the urinary bladder or flanks, myelomeningocele wound, and an exploratory wound. The main complaint was the fever (100%), early meningeal symptoms (50%). Ten patients treated with new distal tube insertion (83.3%) and 2 patients revision of the same distal end done (16.7%). Demographic data, site of migration, treatment protocol and subsequent related morbidity and mortality and outcome on follow up recorded. Conclusion: Close follow up with early detection of the shunt complication may secure us for going to abnormal rare complications.