Results and complications during the first two years after shunting are compared in two groups of 100 consecutively operated hydrocephalus children having either ventriculo-peritoneal or ventriculo-atrial shunt. One of the major reasons for revision of both types of shunts was obstruction at the ventricular end. This accounted for 18 out of 72 atrial shunt revisions and 20 out of 51 peritoneal shunt revisions. Atrial shunts required 21 revisions because of problems with cardiac end and peritoneal shunts required 17 revisions because of problems with peritoneal end. 25 patients with atrial shunt and 12 with peritoneal shunts died to shunt-related complications during first two years of placement. After this comparative study author feels that peritoneal shunt should be first choice in most forms of hydrocephalus in children due to its lower incidence of revision, serious infection and morbidity.