To evaluate the efficacy and safety of laparoscopic ventriculoperitoneal shunt (VPS) surgery in children with hydrocephalus. Methods: We included 56 pediatric patients with hydrocephalus into the study and divided them into the laparoscopy group and control group, with 28 patients per group, according to the type of surgery received. The laparoscopy group underwent laparoscopic VPS surgery and the control group received traditional VPS surgery. The duration of surgery, improvement of clinical symptoms (Kamofsky score), efficacy of surgery (Salmon standard), complications, and serum levels of neuron specific enolase (NSE) and S-100 protein were assessed and compared between the two groups. Results: Compared with the control group, the surgery duration and postoperative exhaust time were significantly shorter in the laparoscopy group (P<0.01). The Kamofsky scores of both groups after surgery were significantly higher than those before surgery (P<0.01), and those of the laparoscopy group were significantly higher than those in the control group (P<0.05). The total effective rate of the laparoscopy group was 85.71% which was significantly higher than the 60.71% of the control group (P<0.05). The incidence of complications in the laparoscopy group was 10.71% which was lower than the 39.29% of the control group (P<0.05). There was no significant difference between the two groups in serum levels of NSE and S-100 protein before surgery (P>0.05). The serum levels of NSE and S-100 protein in each group after surgery showed a significant difference when compared to the same group before surgery (P< 0.01). The serum levels of NSE and S-100 protein in the laparoscopy group 3 days after surgery were significantly lower than those of the control group (P<0.05). Conclusion: Compared to traditional VPS surgery, laparoscopic VPS surgery can significantly improve efficacy in the treatment of children with hydrocephalus and reduce the incidence of complications; it is a safe and effective surgical method