Background: Idiopathic intracranial hypertension (IIH) is a syndrome of unknown etiology resulting in increased intracranial pressure (ICP). Traditional options for medically refractory patients are CSF diversion or optic nerve sheath fenestration (ONSF). Objective: to evaluate lumbo-peritoneal shunts in the treatment of idiopathic intracranial hypertension (IIH). Patients and methods: A prospective clinical cohort study which including twenty two patients fulfilling the modified Dandy criteria for the diagnosis of IIH and were medically refractory underwent a lumbo-peritoneal shunt and were followed up for mean 26.5±3.23 months in Benha University hospital. Results: headache improved in ten patients (45.5%). Gradual resolution of papilloedema occurred with complete resolution of papilloedema in 4(18.2%), 14(63.6%) and 22(100%) patients at 2, 3 and 4 weeks postoperative respectively which is statistically significant. Conclusion: Lumbo-peritoneal shunts are effective in treating idiopathic intracranial hypertension with transient and even mild complications.