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Normal pressure hydrocephalus (NPH) is characterized by a classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure. Because many patients do not present with classical clinical and radiological findings, its diagnosis and management represents a challenge for the treating doctor. Various supplemental preoperative tests, including lumbar CSF tap test or CSF outflow resistance determination, can improve the accuracy of predicting a response to surgical intervention. CSF shunt results in significant reduction of the symptoms in the majority of appropriately evaluated patients.