The pediatric flatfoot can include multiple planes of deformity and concomitant concerns such as metatarsus adductus and equinus. Each aspect of the deformity must be carefully evaluated before any surgical planning. The goal of surgery should be an improvement in symptoms by creating a controllable foot with a reduction of deforming forces. There are multiple procedures that can be used for the pediatric flatfoot, including the Evans calcaneal osteotomy, the Cotton medial cuneiform osteotomy, the medial calcaneal slide osteotomy, and arthroereisis implants. Each contributes in a specific way to the overall deformity correction. Multiple options exist for grafts and hardware.