A prospective study was initiated to investigate parents' and doctors' attitudes towards how the follow-up of children treated with shunts for hydrocephalus should be undertaken. Twenty-three out of 85 (27%) of families whose children had been treated more than 6 months previously failed to attend for their clinic appointment compared with 15% of those attending for other (non-hydrocephalus-related) problems. The possible reasons for this discrepancy have been analysed together with the results of a questionnaire filled in by both the parents and the clinic doctors at the time of the appointment. Although both parties felt that there was a sizeable group of patients for whom continuing neurosurgical follow-up was no longer required there was little concordance in identifying who these patients actually were. Also taken into account were the economic factors which influence both parental and medical decision-making. In the light of our study, new ways of managing the follow-up of these children have been formulated.