BACKGROUND In a patient with hydrocephalus, the placement of a ventriculoperitoneal shunt is the first treatment of choice. Cerebrospinal fluid ascites is a rare complication of a ventriculoperitoneal shunt, particularly a late complication which can arise more than two years after the implantation of the shunt. METHODS We describe a 29-year-old woman who developed cerebrospinal fluid ascites 15 years after a ventriculoperitoneal shunt had been placed. She was referred due to abdominal pain. Ultrasound showed ascites and a CT scan showed free fluid in all of the abdominal compartments. The ascites disappeared after a ventriculoatrial shunt was placed. CONCLUSIONS This case demonstrates that cerebrospinal fluid ascites can occur as a late complication, years after the placement of a ventriculoperitoneal shunt.