In this article we reported pneumocephalus, which developed ten years after a ventriculoperitoneal shunt operation. The operation was performed to treat hydrocephalus secondary to stenosis of aqueduct . In this case, the cause of pneumocephalus was frontal sinus fistula that occurred as a result of increased intracranial pressure due to the dysfunction of the ventricular shunt end. This uncommon complication is reviewed with the pertinent literature and the management is discussed.