The epidemiology of cerebrospinal fluid (CSF) shunting in the United States is not well known; however, with recent national surveys, the prevalence, incidence, and cost of these procedures can be estimated. The prevalence of CSF shunts in the United States appears to be greater than 125,000, though this is likely an underestimate of the true value. There are approximately 69,000 discharges each year with the diagnosis of hydrocephalus. These visits produce nearly 36,000 shunt-related procedures, 33,000 of which involve the placement of a shunt. CSF shunting procedures account for almost US$ 100 million of national health care expenditures each year. Unfortunately, nearly half of these dollars are spent on revision. The rates and costs of CSF shunting underscore the need for continued improvement in both materials and techniques.