Background:The most prevalent parasite disease of the central nervous system is neurocysticercosis, which is an infection of the central nervous system with the larval cysts of Taenia solium. In IVNCC hydrocephalus manifests as headache, nausea, vomiting, light headedness, and impaired vision. Acute blockage caused by changes in head position is sometimes linked to abrupt onset of symptoms also know as Bruns syndrome. We describe the third ventricular neurocysticercosis excision via open microscopic transcallosal approach en bloc removal of the cyst complex Case Description: We describe the excision via transcallosal approach en bloc removal of the cyst complex in a 21-year-old female patient who presented with sudden onset of severe headaches, intermittent vomiting, increased headaches while changing head position CT imaging demonstrated moderately dilated lateral ventricles, significantly more on right side with transependymal CSF ooze and associated with midline shift 10.1mm s/o obstructive hydrocephalus. On MR scan T1 weighted images the lesion shows eccentric focus within, concerning for scolex.The patient was positioned in semi setting and underwent a microsurgical resection of the cyst without rupture through a transcallosal approach to the third ventricle. Conclusion:With time, endoscopic procedures have improved and are now seen as a viable substitute for microneurosurgery. Still there is some limitations to endoscopy like difficulty in radical cyst excision which is attached to the roof of third ventricle. The surgeon operating on a neurocysticercosis should be aware of all the possible approaches to the lesion and should be able to choose the best route. Open surgical procedure in the era of endoscopy was used to successfully treat the patient, avoiding the need for a ventriculoperitoneal shunt.