Acute intraoperative intraventricular hemorrhage is a feared event in endoscopic neurosurgical procedures. To describe the small-chamber irrigation technique (SCIT) for intraoperative endoscopic management of intraventricular hemorrhage. The SCIT was used in intraventricular surgery for hydrocephalus, intraventricular tumors requiring biopsy, arachnoid cysts, and colloid cysts. Intraventricular hemorrhage was successfully managed endoscopically with a combination of the SCIT, routine irrigation, and coagulation, allowing for completion of the primary procedures. The SCIT is a powerful tool that the neuroendoscopist can use for visualization to achieve hemostasis when performing intraventricular endoscopic surgery.