Hydrocephalus, characterized by abnormal cerebrospinal fluid accumulation, is typically diagnosed using MRI or CT. However, these methods face challenges in accessibility, cost, and radiation exposure. Mobile low-field strength MRI (ML MRI) offers a promising, cost-effective, and portable alternative, but its accuracy in hydrocephalus diagnosis has not been fully explored. To assess the diagnostic accuracy and clinical feasibility of ML MRI for hydrocephalus, comparing it with CT and 3.0T MRI. In this retrospective cohort study, 130 patients with suspected hydrocephalus underwent ML MRI, CT, and 3.0T MRI. Key ventricular measurements were compared across modalities. Diagnostic performance was evaluated using intraclass correlation coefficients (ICC), Bland-Altman analysis, and ROC curves. ML MRI demonstrated high diagnostic accuracy, with ICC values >0.95 compared to CT. The area under the curve (AUC) for ML MRI was 0.943, closely matching CT (AUC 0.954) and 3.0T MRI (AUC 0.975). Sensitivity, specificity, and accuracy for ML MRI were 96.00%, 96.67%, and 96.15%, respectively. Bland-Altman analysis confirmed high consistency across modalities. ML MRI offers high diagnostic accuracy and consistency with conventional methods, making it a promising tool for hydrocephalus diagnosis, especially in resource-limited settings. Its advantages-low cost, portability, and no radiation exposure-support its use for both initial diagnosis and long-term monitoring.