BACKGROUND: Shunt infections are one of the most serious and costly complications associated with shunt therapy. They can have long-term consequences to the patient and impose significant burden on the family and health care system. OBJECTIVES: To investigate the clinical and economic value of AISC in the treatment of Hydrocephalus. METHODS : A search of the Embase, PubMed, and NHS EED electronic databases was conducted to identify studies evaluating the effectiveness, efficacy and economic aspects of AISC’s in patients with Hydrocephalus. No language restrictions were applied. RESULTS: Twenty-three clinical and 9 economic studies were included for review. The majority of published studies using AISC in the treatment of hydrocephalus demonstrated a statistically significant reduction in shunt-associated infections when AISC vs. standard shunt (SS) catheters were used. One meta-analysis of 14 studies that compared patients implanted with AISC to SS catheters showed AISC to be protective against shunt infection in both paediatric and adult Hydrocephalus patients. The pooled infection rate decreased from 7.0% in the SS catheter group to 3.5% in the AISC group. Economic studies conducted globally reported significant cost savings associated with using AISC. One study in paediatric Hydrocephalus patients found that ongoing management of shunt infections uses a disproportionate amount of hospital expenditure (71% of total management costs or €57,650 per patient) when compared to shunt revision surgery (29% of total costs or €6,720 per patient). Using shunt implant data from the UK Hospital Episode Statistics (HES), procedures and interventions database, we estimated the potential cost savings to the UK Health Care system in 2012-13 was £1,461,207 if all new lumboperitoneal or ventriculoperitoneal shunt surgeries were performed using AISC systems. CONCLUSIONS: Current clinical evidence has demonstrated AISC reduce infection rates in shunted Hydrocephalus patients. The potential healthcare savings associated with reduced infection rates are significant.