Background: Endoscopic Third ventriculostomy (ETV) is the most physiological treatment for managing hydrocephalus. Materials and Methods: Prospective Observational study was done at the NRSMCH Kolkata -700014 ,on patients of hydrocephalus undergoing management via ETV in our setting. 25 patients were included and assessed for neurological and radiological parameters along with complication profile. Results: The baseline demographic parameters and clinical/radiological parameters were studied. Most common indication for ETV was aqueduct stenosis followed by lesions of the posterior fossa (tumors or bleeds). ETV had a rate of success 85% in conventional group. Almost all the patients experienced a significant improvement in the Evans Index and FOHR postoperatively. It had a complication rate 45%. Conclusion: ETV was an equally efficacious and safer technique than the conventional shunting.