Objective and Importance: Complications arising from the placement of ventriculoperitoneal (VP) shunts are well documented. A case of infertility is presented that was thought to result from factors related to the distal end of a VP shunt residing within a patient's abdomen. Clinical Presentation: A 30-year-old female with a 3-year history of infertility was referred for fallopian tube blockage. An exploratory laparoscopy revealed multiple adhesions adjoining the distal end of her fallopian tubes. The distal portion of a VP shunt placed at childhood (with subsequent revisions) was found entangled among grossly inflamed and densely adhesive pelvic viscera. Intervention: Laparoscopic adhesiolysis was performed and the patient's fallopian tubes were reconstituted. The distal portion of the VP shunt was freed from the surrounding viscera and was not revised. Conclusion: VP shunts may produce adhesive disease and complicate fertility via mechanical, chemical, and/or infectious processes. Copyright © 2007 S. Karger AG.