Spinal deformities can occur at all stages of the life course, but given the developmental characteristics of the spine and lungs, children with scoliosis often face unique challenges and treatment considerations. Early-onset scoliosis (EOS) is commonly defined as a severe, complex deformity of the spine and thorax in children under 10 years of age. In fact, treatment strategies and prognosis for early-onset scoliosis differ significantly from those for other types of scoliosis due to significant differences in incidence, co-morbidities, and especially natural history. Early-onset scoliosis encompasses a variety of different spinal conditions and is defined only by age and presentation as a spinal deformity. The etiology of scoliosis in the early-onset scoliosis population varies widely and includes congenital scoliosis (e.g., congenital vertebral body formation and segmentation insufficiency), structural scoliosis (e.g., scoliosis due to rib fusion, abnormal chest wall development, and congenital diaphragmatic hernia), scoliosis due to neuromuscular disease (e.g., cerebral palsy and myotonic dystrophy), syndrome-related scoliosis such as neurofibromatosis, VACTERL (vertebral anomalies, anal atresia, cardiac malformations, tracheoesophageal fistula, renal abnormalities and limb defects) and scoliosis of unknown etiology (e.g. idiopathic scoliosis). The degree of cognitive and functional impairment and medical intervention in this group varies. The true prevalence of early-onset scoliosis remains unclear, but accounts for approximately 10% of all pediatric scoliosis cases The clinical treatment goals for early-onset scoliosis include controlling the progression of the deformity, maximizing thoracic volume, enhancing functional and health-related quality of life, minimizing complications, and reducing adverse effects of treatment.