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AIM To determine whether the timing of shunt placement affects shunt infection rate in hydrocephalus associated with myelomeningocele (MMC). MATERIAL AND METHODS The cases of 67 consecutive patients who underwent MMC repair and ventriculoperitoneal (VP) shunt placement between 2010 and 2017 were analyzed retrospectively. Shunt infection rates were compared for three different approaches: simultaneous shunting (MMC repair and shunting in the same session; n=22), early shunting (shunting in the first week after MMC repair; n=21), and delayed shunting (shunting in the second week after MMC repair; n=24). RESULTS There were 22 patients in the simultaneous shunting group, 21 patients in the early shunting group and 24 patients in the delayed shunting group. Three patients in the simultaneous shunting group (13.6%) and two patients in the early shunting group (9.5%) developed shunt infection, whereas no such infections occurred in the delayed shunting group (p 0.05). CONCLUSION While the shunt infection rates for the simultaneous, early and delayed shunting groups were not significantly different, it is of interest that no shunt infections occurred in the delayed shunting group. Investigation with a larger number of patients is warranted to assess whether delayed shunting might reduce the risk of shunt infection.