Although various guidelines and consensus statements have been developed for cerebrospinal fluid （CSF） shunt infection in patients with hydrocephalus， there are still great differences in the actual treatment strategy given by different clinicians. A considerable proportion of clinicians may choose conservative treatment for various reasons. This article reports a patient who received conservative treatment due to shunt infection and shunt tube occlusion at the abdominal end. Since initial antibiotic therapy seemed effective， the patient only received laparoscopic correction of shunt tube occlusion at the abdominal end， followed by long-channel external ventricular drainage due to poor control of infection， and ventricle-atrium shunt was performed again after infection was controlled completely. This case is shared to clarify the complexity of treatment decision-making regarding shunt infection， briefly discusses the possibility and feasibility of conservative management， and introduces the technique of long-channel external ventricular drainage for safe clearance of infectious CSF.