Abstract Purpose We characterized the occurrence of ventriculoperitoneal shunt infections after augmentation cystoplasty. Materials and Methods We reviewed the records of 20 myelodysplastic children with ventriculoperitoneal shunts followed for a minimum of 12 months after augmentation. Results In 4 children (20 percent) a ventriculoperitoneal shunt infection developed. The single gram-positive infection occurred early (less than 30 days). The 3 gram-negative infections were delayed presentations (greater than 30 days). Organisms in 2 of the 3 gram-negative infections had been noted in a preoperative urine culture. Conclusions Ventriculoperitoneal shunt infection after bladder augmentation is common. Delayed presentation of shunt infections may indicate gram-negative infection. Sterilization of the urinary tract is indicated before augmentation.