BACKGROUND AND OBJECTIVES: Current techniques to detect obstruction of ventriculo-peritoneal (VP) shunts are costly, invasive, and time-consuming. This study examines the efficacy of using point-of-care ultrasound (POCUS) to identify shunt nonpatency. METHODS: We conducted a single-center observational cohort study on patients with medium-pressure VP shunts for hydrocephalus. POCUS was used to evaluate shunt patency, and the results were compared with computed tomography/MRI/trans-fontanelle ultrasound evaluations for hydrocephalus. RESULTS: Among the 39 patients studied, 17.9% had shunt obstructions. Patients with obstructed shunts, on comparison with patent shunts, had higher optic nerve sheath diameter (ONSD): 4.3 ± 0.2 mm vs 4.1 ± 0.2 mm ( CONCLUSION: Our study supports the novel use of POCUS for detecting sonological signs of VP shunt nonfunction with very high sensitivity and NPV. This technique is quick, safe, and cost-effective, making it an excellent option for outpatient surveillance of VP shunt obstruction.