Background <p>Ventriculoperitoneal shunt (VP) insertion is a common intervention in paediatric neurosurgery, and as outcomes for children with hydrocephalus improve, clinicians are increasingly asked to provide advice beyond the immediate postoperative period. Participation in sport is an important component of childhood development, yet there is limited evidence or consensus guidance to inform recommendations regarding contact sports for children with VP shunts. As a result, clinical advice is often based on individual experience rather that robust data.</p> Methods <p>A structured electronic questionnaire was distributed to members of the British Paediatric Neurosurgery Group (BPNG). Participants were asked about their experience of rugby related VP shunt complications, the levels of rugby participation they would permit at different ages and whether they would recommend the use of protective head gear.</p> Results <p>Overall response rate of 42.8% was achieved (30 of 70 respondents). Only one respondent (3%) reported direct experience of rugby related shunt complication. All respondents would permit a 7-year-old with a VP shunt to participate in touch rugby. 80% would allow a 14-year-old to play contact rugby, and 77% would permit an 18-year-old to participate in professional or elite rugby. The use of a scrum cap was recommended by 77% of respondents.</p> Conclusions <p>Most paediatric neurosurgeons support return to rugby for children with VP shunts, commonly recommending protective headgear. These findings support the importance of providing informed, individualised guidance for resuming play.</p>