In Neurosurgery, shunt systems are utilized for a variety of diagnoses, some of which include: hydrocephalus, subarachnoid hemorrhage, normal pressure and pseudominengocele following craniotomy. With the placement of hardware foreign to the natural body, there are complications that can arise from placing these systems. It is not uncommon that many Neurosurgery services, providers and nursing teams become accustomed to patients with shunts experiencing symptoms that suggest failure or complication. When patients present with failure symptoms, different diagnostics tests need to be conducted to evaluate for shunt failure. Shunt obstructions account for approximately 50% of shunt failures. Other complications include: infection, subdural hematoma and abdominal complications. This lecture aims to review the signs and symptoms that may indicate shunt failure and discuss the different diagnostic workup and treatment plans for patients with different shunt complications.