SUMARY Treatment of syringomyelia with ventriculoperitoneal shunt: Case report. The ventriculoperitoneal shunting procedure may be first choice of treatment in patients harboring communicating syringomyelia associated with enlarged cerebral ventricles. In this report, a patient with communicating syringomyelia who was treated by inserting a ventriculoperitoneal shunt is presented. A 41-yeard-old man was admitted to our clinic with the complaints of hoarseness and weakness in all four extremities. Magnetic resonance imaging of the head and cervical spine revealed the presence of a type I Chiari malformation and syringomyelia associated with enlarged cerebral ventricles. Neurological symptoms improved dramatically after operation. Six months later, a control magnetic resonance imaging was performed to find out that the syrinx and the tonsillar hernation as well had disapperared completely. The patient was still in good neurological condition when he was lost to follow-up 7 years after operation. The accurate treatment of syringomyelia relies upon the understanding of dynamics of cérébro-spinal fluid and choosing the appropriate surgical procedures. Ventriculoperitoneal shunting should be considered as the initial treatment modality in the case of cervical syringomyelia associated with enlarged ventricles.