Objective To summarize the experience of ventriculo-peritoneal (V-P) shunt under micro-laparoscope for the treatment of hydrocephalus. Methods Twenty-eight patients with hydrocephalus were treated by V-P shunt under micro-laparoscope from November 2000 to May 2004. An infraumbilical trocar was placed through a 5 mm incision to introduce the operating laparoscope. Under laparoscopic visualization, a 3 mm trocar was introduced into the abdominal cavity along the right side of the ligamentum teres hepatis through an incision just to the right of the xiphoid process. A 1.5 mm subcutaneous incision at the corresponding site of the diaphragmatic surface of the liver on the right anterior axillary line was made and through it a sewing needle with 4-gauge unabsorbable silk suture was delivered into. A grasping forceps was inserted through the xiphoid port into the abdominal cavity to carry the two sides of the suture out. The V-P tubing was fixed in the interspace between the liver and the diaphragm by the ligation from the outside, and then was tunneled to the head. Results All the operations were successfully accomplished. The operation time for iutraabdominal tube placement was 5~10 min.All the patients experienced complete alleviation of symptoms of intracranial hypertension postoperatively. No surgical complications occurred.Follow-up check-ups for 6~36 months(mean,12 months) in 25 patients found no tube obstruction. Conclusions Ventriculo-peritoneal shunt under micro-laparoscope has the advantages of minimal invasion, precise positioning, excellent visualization and rapid recovery, being a safe and feasible method which is worthy of recommendation.