Cerebrospinal fluid (CSF) diversion procedures remain the principal method of treatment of hydrocephalus and an important option in treating idiopathic intracranial hypertension. Recent advances in CSF shunt hardware offer some promise in reducing the rate of complications. Third ventriculostomy has become an increasingly practiced alternative to conventional shunting in an ever-widening patient population. Long-term follow-up studies have identified complications of lumboperitoneal shunt placement. Advances in surgical navigation suggest that ventriculoperitoneal shunting may be a viable alternative in patients with idiopathic intracranial hypertension.