Premature infants are at a heightened risk of intracerebral or intraventricular hemorrhages (IVH), which often lead to posthaemorrhagic hydrocephalus and necessitate the placement of a ventriculoperitoneal (VP) shunt. Here, we present a case involving suspected ICH, which led to multiloculated hydrocephalus, recurrent ventriculitis, and meningitis. This case study highlights the complexities of managing infections and the importance of endoscopic surgery in restoring CSF flow. It also sheds light on the long-term developmental outlook when treating premature infants with multilocular hydrocephalus.