Introduction: Ventriculoperitoneal (VP) shunting continues to be the standard treatment for hydrocephalus. Although considered relatively safe, it is associated with recognized complications such as infection, obstruction, and mechanical failure. Abdominal complications of VP shunts include extrusion through the surgical incision and migration of the catheter into different intraabdominal compartments. Bowel perforation with transanal catheter extrusion is a rare but well-documented event, occurring in approximately 0.1%–0.7% of cases. Case presentation: We report a 15-month-old girl with schizencephaly and communicating hydrocephalus who underwent left-sided VP shunt placement at 8 months of age. At 15 months, she presented with a history of a tube protruding from the anus, associated with clear fluid discharge, without fever or other systemic manifestations. On clinical evaluation, there were no signs of peritonitis, meningitis, or systemic sepsis. Rectal examination confirmed extrusion of the catheter through the anus. Abdominal ultrasonography revealed no intra-abdominal collection, while plain abdominal radiography confirmed distal catheter migration into the bowel lumen. In coordination with pediatric surgeons, the proximal shunt was externalized, and the distal segment was carefully removed transanally . Empirical broad-spectrum intravenous antibiotics were commenced, and cerebrospinal fluid analysis and cultures remained sterile. Conclusion: Transanal extrusion of a VP shunt may occur insidiously , without evidentabdominal or central nervous system infection. Maintaining a high index of suspicion, timely shunt externalization, appropriate antibiotic therapy , and delayed contralateral reinsertion are essential for favorable outcomes. Early multidisciplinary intervention plays a pivotal role in preventing severe infectious complications.