Background: hydrocephulus is characterised as excessive production of cerebrospinal water or reduced drainage of CSF. It may be handled by a peritoneal ventricular shunt but it might be complicated by blockage or infection. Management can be done by either revising the peritoneal end repeatedly or transforming it into a ventricular atrial shunt. (1) Purpose: This study intends to assess the effectiveness, in comarison to replacement with ventricula atrrial shunt, of repeated distal ends of peritoneal ventriculum shunt revision. Design of the research: this is a retrospective study. Patient and method: This study is a retrospective study that includes 60 distal end-stroke patients operated by repeated remote end revision (group I), or transformed to a ventriculum atrial shunt (group II), at the Benha University and Benha Children's Hospital neurochirurgical departments in January 2018 to January 2020. All patients were evaluated via thorough general, neurochirurgical and radiological assessments. The patient was followed up from 12 to 18 months after surgery. Results: 60 individuals with a median age of ±SD 37.22 ± 41.94 months were examined. The results of group I operations were replaced by 14 patients (30.4%) and 32 patients (69.6%) failed. Group II succeeded nine patients (64.3%), and failed five (35.7%), which is statistically significant. Conclusion: success rate in the ventriculoatrial shunt in repeated ventriculoperitoneal distal revision in repeat distal shunt problem is greater than success rate.