Congenital spinal deformity is a common spinal deformity caused by abnormal development of the spinal structures during embryonic life. Most common congenital spinal deformities in clinical practice are a combination of lateral and anterior convexity or lateral and posterior convexity; simple congenital anterior or posterior spinal convexity is very rare. The etiology of the disease is unclear, and many factors such as environmental factors, genetics, medication application during pregnancy, and chemical exposure can affect spinal development. Congenital spinal deformities are mainly due to structural abnormalities that result in asymmetric spinal growth and are classified according to their radiographic manifestations. The majority of congenital spinal deformities are progressive and have a poor prognosis, and patients may develop neurological symptoms due to spinal cord compression, especially with kyphosis. Early onset deformities have a significant impact on thoracic development and limit cardiopulmonary development. The progression of the deformity is caused by a growth imbalance on both sides of the spine, and in order of risk of progression, unilateral undissected bridges combined with contralateral hemivertebrae progress most rapidly, followed by unilateral undissected bridges, two hemivertebrae on the convex side, single fully dissected hemivertebrae in the thoracic and thoracolumbar segments, and cuneiform vertebrae, with the least risk of progression being masseter vertebrae. The progression of deformity is usually faster during the growth period (before 5 years of age and during adolescent development). The thoracic and thoracolumbar deformities progress more rapidly, while scoliosis is less severe in the cervicothoracic and lumbar segments. Deformities of the lumbar segment generally do not cause significant cosmetic abnormalities unless they are associated with deformity loss or pelvic tilt.