Cerebrospinal fluid (CSF) is an essential component of the central nervous system, and disruption of normal CSF flow from the lateral ventricles to the subarachnoid spaces around the brain and spinal canal can have serious consequences. Nuclear imaging may be useful to help diagnose abnormalities in CSF flow; cisternograms can be used to assess for CSF leaks or normal-pressure hydrocephalus, and shuntograms can be used to evaluate for CSF shunt malfunction. The authors review normal and pathologic findings and pitfalls of cisternography and shuntogram examinations. ©RSNA, 2025.