The treatment goal for pediatric cavovarus deformities is to neutralize plantar pressure distribution, reduce hindfoot varus deformity, and avoid or postpone ankle, midfoot, and hindfoot arthritis. If nonoperative treatment is not sufficient, surgical realignment must be discussed. Promising improvements in decision making and operative techniques have been published. To avoid disappointment owing to recurrence or failures of operative procedures, selection of the appropriate and preferably single operative procedure remains the most crucial factor for success. This article focuses on current treatment options depending on the localization of the anatomic pathology. Outcomes of nonoperative and operative treatments are presented.