Objective: The present study descrives our clinical experiences, by looking at the results of a single surgeon, in selecting shunt system in the elderly patients with hydrocephalus. Patients and Methods: Patients with symptomatic hydrocephalus that lasted 3 weeks or longer after the original symptoms were treated with placement of peritoneal shunts. A catheter with high pressure valve, Accu flo in 36 cases and Hakim progrmmable valve in 8 cases were used. Outcome after shunting varied a little according to pre-shunt neuological grade, and thus a response to shunting was assessed by the change of modified stein and Langfitt scale.Results: The outcome except two patients was improved. There were no shunt-related infectons, however there had been two cases of obstruction at peritoneal end. The obstructed shunt was revised and the patients were improved. In a elderly patient, a catheter with high pressure valve was converted to Hakim programmable valve, and was subsequently improvedConclusion: There are several types of shunt systems. Thus, the selection of a shunt system in each method is different according to the surgeon's preference because all shunts have advantages and disadvantages. Our study results suggest that Hakim progrmmable balve, if patients' conditions are not risky to general anesthesia, is a better choice of treatment than high pressure valve in the elderly patients with chronic hydrocephalus.