Mechanical shunting of cerebrospinal fluid (CSF) is an effective treatment for hydrocephalus. Although ventriculoperitoneal (VP) shunting is the most common treatment [1], there are a number of complications associated with this technique [1] including obstruction, mechanical shunt failure and infection and, in 10–30% of patients, abdominal complications. Reported abdominal complications include CSF ascites, peritoneal cyst, pseudotumor of the mesentery, inguinal hernia, volvulus, peritonitis, intestinal obstruction, as well as migration of the catheter through the vagina, scrotum, umbilicus, and intestinal tract [2]. Bowel perforation following VP shunting is extremely rare, accounting for only 0.01–0.07% of abdominal complications, but carrying a mortality rate of approximately 15% [3]. The most common site of bowel perforation is the colon [4], and more than 50% of these patients are asymptomatic with the most common presentation being protrusion of the shunt catheter through the anus [5]. We report an 11year-old girl who had anal VP shunt protrusion 12 days following surgery, without any signs of peritonitis, bowel obstruction, and ventriculoperitoneal shunt (VPS) malfunction or infection, and review the literature on this rare, but serious complication.