Intraventricular cysticercosis is potentially lethal. Six of 46 patients died from acute hydrocephalus shortly after hospital admission. The need for early computed tomographic scanning in immigrants from endemic areas complaining of headaches is emphasized by this experience. If time has elapsed since the initial diagnosis, these cysts may migrate within the ventricular system. Reconfirmation of the location of an intraventricular cysticercal cyst is advisable before surgery. Contrast enhancement of an intraventricular cysticercal cyst implies associated granular ependymitis. Surgical removal of such cysts probably should not be attempted as long as the cysts are not causing significant mass effect with neurologic signs and symptoms. Shunting alone is advocated for the treatment of hydrocephalus.