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Leg length discrepancies have multiple causes with a number of treatment options available to accomplish a goal of equal or near equal leg lengths at skeletal maturity. The management of a deformity in the lower extremity can be a complex undertaking requiring the skill and expertise of a multidisciplinary health care team. The purpose of this article is to provide an overview of how a treatment plan is formulated after careful evaluation through ongoing assessment, diagnosis, treatment, and follow-up. The plan of care needs to fit the needs of the child and those of the family through realistic goal setting, ongoing teaching, and support.