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Shahid Beheshti University of Medical Sciences, Department of Neurosurgery, Tehran, Islamic Republic of Iran DOI : 10.5137/1019-5149.JTN.3268-10.2 We report the safety and efficacy of bilateral foraminoplasty of Monro in a patient with partial occlusion of right Monro and complete occlusion of the left one. A 38-year-old man who underwent a ventriculoperitoneal shunt three years ago, and shunt revision surgery twice, presented with hydrocephalus, and was referred to us because of continuing complaints of headaches, nausea and vomiting. The primary surgical treatment of the patient was bilateral endoscopic Monro foraminoplasty. Then, the patient did not need a ventriculoperitoneal shunt, and hydrocephalus was resolved. Bilateral monroplasty in a single-session surgery can be the treatment of choice, instead of microsurgically open reconstruction of the foramen of Monro. The procedure can be less invasive, and it avoids ventriculoperitoneal shunting. Keywords : Foramen of monro, Foraminoplasty, Hydrocephalus, Neuroendoscopy