Author(s): Majji Chandra Sekharam Naidu BACKGROUND Club foot is the most common congenital disorder in orthopaedics. Over the years, many different forms of treatment ranging from gentle manipulation and strapping, serial plaster corrections, forcible manipulations including the use of mechanical devices to surgical correction have been tried. Ponseti method is being used recently for treatment of club foot. The clinical correction achieved by using this method has produced a functional, plantigrade foot without requiring posteromedial release in 85% to 90% of cases.1 Long-term follow-up studies show that feet treated by Ponseti management are strong, flexible, and pain free. These studies prove that Ponseti management of clubfoot is best for all countries and cultures. The objective of the study is to evaluate the demographics of club foot. To assess the role of Pirani score in assessment of club foot. To study the relation between initial Pirani scores and outcome. MATERIALS AND METHODS In the present case series, 34 cases of idiopathic clubfoot were treated by Ponseti method and evaluated by Pirani scoring system. The cases were followed up weekly and cases which needed tenotomy were operated after other deformities were corrected. RESULTS Male:Female sex ratio was 2.4:1. Bilaterality in 30% of cases was seen with right-sided being slightly more common. Group 2 cases were more common than Group 1 and 3. 94% of cases required tenotomy. CONCLUSION Ponseti method of conservative management is very effective in treating idiopathic clubfoot. Results corelated with initial Pirani score. Tenotomy was necessary in most of the cases to correct the equinus deformity. Bracing protocol has to be strictly followed for maintenance of correction.