Adult scoliosis is a curvature of the spine to the side after skeletal maturity and generally refers to scoliosis with a coronal plane greater than 10° of cobb angle after the age of 20 years. Adult scoliosis can be further divided into scoliosis that occurs before skeletal maturity, including idiopathic, congenital, and neurogenic, and scoliosis that occurs newly after skeletal maturity, including scoliosis secondary to degenerative disease, medical origin, trauma, and osteoporosis/osteochondrosis. The majority of outpatients are seen for curves that began as idiopathic curves in adolescents or curves due to degeneration, often resulting in pain, loss of balance, and progression of scoliosis due to spinal degeneration in adults. In the past, it was thought that scoliosis would not develop in adults, due to the high risk of surgery and mainly conservative treatment, but clinical and many research studies have concluded that idiopathic scoliosis is still progressive after skeletal maturity, observed that scoliosis of the thoracolumbar spine greater than 50 progresses 1 – 2 ° per year, and clinical symptoms can occur, advocating orthopedic treatment to maintain the balance of the spine, prevent further development and relieve pain. Treatment is divided into non-surgical and surgical: The basic approach to non-surgical treatment is the same as for all chronic painful spinal symptoms and includes exercise, patient education, non-steroidal anti-inflammatory medications and behavior modification. Medications and exercise do not prevent the exacerbation of scoliosis, but may maintain the flexibility, improved function, endurance, and quality of life that it has, and physical activity is beneficial to prevent osteoporosis. The role of orthopedic brace therapy is unclear, and there is no evidence that it can prevent the progression of scoliosis. However, in some cases it can be beneficial. Indications for surgical treatment of adult scoliosis patients include: 1) persistent pain that has failed conservative treatment; 2) significant deformity progression; 3) nerve involvement; and 4) a requirement for cosmetic improvement. Adult spinal deformities are diverse and challenging, requiring comprehensive skills and an experienced spine surgeon. With the improved level of modern medical technology and intensive research, a good set of treatment methods is available. Each patient undergoes a detailed examination, a thorough evaluation, careful analysis, precise preoperative preparation and treatment goals, followed by a careful and deliberate surgical operation. Both the doctor and the patient can achieve a pleasant goal.