Infantile and juvenile scoliosis are both forms of early onset scoliosis (EOS). Juvenile scoliosis (JS) is defined as scoliosis first diagnosed between the ages of 4 and 10 yr, while infantile scoliosis (IS) is defined as scoliosis that is first diagnosed between birth and 3 yr of age but before age 4. The diagnosis and management of these patients continue to remain a challenge to providers. Advanced imaging often is necessary to delineate anatomy and assess for any spinal cord abnormalities that may be contributing to the deformity. Early recognition and treatment may help facilitate treatment. Treatment of these patients may require both nonoperative and operative treatment modalities. Casting and bracing often are used as methods to try and control the curvature until patients are old enough for surgical intervention. Operative treatment for complex spinal deformity may require the use of spinal osteotomies. These osteotomies may be utilized in both pediatric and adult spinal deformity patients. A thorough understanding of each osteotomy is necessary to help properly plan surgical procedures and obtain the desired correction.