Avoiding threatened ventriculostomy shunt exposure in the pediatric population remains a difficult problem for the neurosurgeon and reconstructive surgeon. In this case series, the authors present a novel method of augmenting scalp soft tissue with acellular dermal matrix (ADM) in patients with a history of ventricular shunt revisions. Soft tissue augmentation with ADM successfully prevented shunt exposure in 3 patients with a history of shunt revision due to impending exposure following conventional techniques.