ABSTRACT
Dandy walker syndrome is a kind of congenital anomaly consisting of absence of cerbellar vermis, cystic fourth ventricle and large posterior fossa. It can be associated with hydrocephaly. Generally it is treated with shunting but endoscopic third ventriculostomy can also be used. Our patient is a known case of dandy walker syndrome. She has been shunted due to hydrocephaly when she was 5 months old. She was presented with signs of raised intracranial pressure and endoscopic third ventriculostomy [ETV] was considered for the patient. As ETV didn't resolve the symptoms ventriculoperitoneal shunting was done. Patient discharged with good general condition. ETV is a novel procedure for hydrocephaly, but it should be considered that there are many factors that determine the success rate of it. Correct patient selection can increase success rate of this procedure