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Extracapsular base of femoral neck osteotomy was performed in 36 hips with moderate to severe slipped capital femoral epiphysis (SCFE). Follow-up ranged from 2 to 24 years (average 9 years). According to modified Southwick's criteria, 90% of the hips had excellent or good result. There were no cases of avascular necrosis (AVN). Prevention of permanent limb-length discrepancy >15 mm, as occurs in unilateral cases, warrants close follow-up and contralateral epiphysiodesis when necessary. We highly recommend this osteotomy as a safe and effective way to prevent further slippage and improve hip range of motion (ROM) in severe chronic slips.