The aim of study was to evaluate the most common congenital/developmental and acquired etiologies that cause Hydrocephalus and their MRI evaluation and the importance of precise diagnosis for pre-treatment and help to plan surgical treatment and follow-up. Material & Methods: The study was carried out on patients with signs and symptoms of hydrocephalus referred from clinical departments and OPD. And an observational study was conducted on a total of 65 patients for this study. A detailed history was taken. All patients were evaluated by MRI scan. Result: In our study most common age group was 0-10 years with 23 patients comprising 21.53% from the total of 65 patients. And the age group of the patient ranged from 2 weeks upto 67 years. From the total of 65 patients; 35 were male (53.84%) and 30 were female (46.15%) with male: female ratio being 1.16: 1. In this study neoplastic etiologies were the most common etiology comprising 53.8% (35 patients) followed by inflammatory causes comprising 16.9% (11 patients) followed by congenital etiologies comprising 10.7% (7 patients). Conclusion: This study evaluated role of MRI in evaluation of patients with hydrocephalus which is considered as a treatable result to any underlying pathology: Different sequences of MRI is very useful in evaluation of hydrocephalus, its types and it’s underlying cause. MRI is useful for further classification of hydrocephalus into obstructive vs non-obstructive and communicating vs non-communicating type along with evaluation of its underlying etiology causing hydrocephalus