Ventriculoperitoneal (VP) shunts in infants with posthemorrhagic hydrocephalus (PHH) are prone to failures, with some patients at risk for multiple revisions. The objective of our study is to observe long-term outcomes and identify factors leading to proximal and distal multiple failures. We performed a retrospective review of infants with PHH that required VP shunt placement between 1982 and 2014. These patients were monitored clinically and radiographically after VP shunt placement. A total of 502 surgical procedures (initial shunt insertion and revisions) were performed, with 380 shunt revisions in 102 (84%) patients. Median shunt survival time was 54months (0.03-220months). Shunt survival was significantly affected by the following factors: intraventricular hemorrhage (IVH, grade II-III, 95months vs. grade IV, 28months, p=0.022), birth weight (<1.5kg, 59months vs. >1.5kg, 22months, p=0.005), gestational age (>27weeks, 90months vs. <27weeks, 20months, p<0.0001), distal vs. proximal revision (133months vs. 48months, p=0.013), obstruction (yes, 78months vs. no, 28months, p=0.007), and infection (no, 75months vs. yes, 39months, p=0.045). Regression analysis revealed that multiple gestation, head circumference (>27cm), congenital anomalies, infection, and obstruction increased the proximal and distal shunt malfunction. Long-term outcome of VP shunt placement in infants revealed a relatively high rate of complications requiring shunt revision as late as 30years after initial placement. Infants with VP shunts should be monitored lifelong of these patients by neurosurgeons.