Surgical management is the only option for patients presenting with acute hydrocephalus caused by intraventricular neurocysticercosis. Although various modalities have been described, endoscopic excision is becoming increasingly popular. The outcomes for 22 patients with intraventricular neurocysticercal cysts with hydrocephalus managed endoscopically are presented. Complete excision of cysts (fourth ventricle, 14; lateral ventricle, 4; third ventricle, 3; both lateral and third ventricles, 1) was performed in all patients. Internal procedures for cerebrospinal fluid diversion were performed in 20 patients. There were minimal perioperative complications, all patients were relieved of raised intracranial pressure and no patient has required shunting to date. Mean follow-up duration was 20.7 months. Follow-up imaging showed the absence of residual cysts and resolution of hydrocephalus in all patients.