Objective To investigate the effect of ventriculoperitoneal shunt (VPS) in the treatment of patients with Cryptococcus neoformans meningitis complicated by marked intracranial hypertension.Methods A retrospective analysis was performed for the clinical data of 22 patients who were diagnosed with Cryptococcus neoformans meningitis complicated by marked intracranial hypertension and underwent VPS in The Third Affiliated Hospital of Sun Yat-Sen University from January 2014 to November 2016. Intracranial pressure before and after VPS, major clinical symptoms, and postoperative complications were analyzed and compared to evaluate the effect of VPS in the treatment of Cryptococcus neoformans meningitis complicated by marked intracranial hypertension.Results Of all patients, 22 achieved a significant reduction in cerebrospinal fluid pressure after surgery (P<0.001), and there were significant improvements in major symptoms such as disturbance of consciousness, headache, visual impairment, and hearing disorder. There were few postoperative complications and no spread of Cryptococcus neoformans infection. There were no significant differences in catheter-related complications between these patients and the patients who underwent VPS due to hydrocephalus.Conclusions VPS can effectively reduce intracranial hypertension and improve clinical symptoms and has few adverse events.