Four hundred ventriculoperitoneal shunt procedures in 280 patients were retrospectively evaluated regarding complications relating to the peritoneal end of the catheter. There were 100 complications requiring 120 surgical revisions. Common complications consisted of mechanical shunt malfunction in 28, catheter tip occlusion in 40 and shunt infection in 25. In addition, there were abdominal cerebrospinal fluid loculations and pseudocysts formation in seven patients, intestinal perforation, migration of shunt tip in the right pleural cavity and intractable ascites in one patient each. The currently available diagnostic imaging modalities by which the peritoneal end of a malfunctioning ventriculoperitoneal shunt can be evaluated are reviewed.