Abstract Background: Normal pressure hydrocephalus (NPH) is a syndrome found in the elderly, which is characterized by the clinical triad of gait disturbance, dementia, and urinary incontinence without overt signs and symptoms of elevated intracranial pressure. NPH has been estimated to account for upto10% of cases of dementia and is significant because it is treatable by ventriculoperitoneal shunting. NPH can be idiopathic or can be secondary. The secondary causes are: traumatic brain injury, meningitis, subarachnoid haemorrhage (SAH) or intracranial surgery. Patients with Idiopathic NPH respond better to treatment than secondary Materials and Methods: It is a prospective cross-sectional study. Inpatients and outpatients of age group more than 40 years of age, of both gender (males and females) diagnosed with normal pressure hydrocephalus as per consensus criteria were referred to Department of Radiodiagnosis from the department of. The patients underwent Magnetic resonance imaging/computed tomography study of brain. Results: A total 40 patients were included in this study according to consensus criteria. Computed tomography (CT) and Magnetic resonance imaging (MRI) show ventricular enlargement disproportionate to cerebral atrophy, with associated ballooning of frontal horns, periventricular hyperintensities, thinning and elevation of the corpus callosum and widening of temporal horns without evidence of hippocampal atrophy in NPH. Conclusion: Although diagnosis can be made based on CT findings alone, MRI is more accurate for disclosing associated pathologies (such as cerebrovascular disease) and for detecting NPH typical signs of prognostic value, besides avoiding exposure to ionizing radiation. MRI is the best modality to image anatomical changes and can further support the diagnosis with CSF flow studies.