Scoliosis is defined as a deviation of the normal vertical line of the spine, consisting of a lateral curvature with rotation of the vertebrae within the curve.^[1] Typically, for scoliosis to be considered, there should be at least 10° of spinal angulation on the posterior-anterior radiograph associated with vertebral rotation (1). The causes of scoliosis vary and are classified broadly as congenital, neuromuscular, syndrome-related, idiopathic and spinal curvature due to secondary reasons. Congenital scoliosis is due to a vertebral abnormality causing the mechanical deviation of the normal spinal alignment. Scoliosis can be due to neurological conditions (eg, cerebral palsy or paralysis), muscular abnormalities (eg, Duchenne muscular dystrophy) or other syndromes (eg, Marfan’s syndrome and neurofibromatosis). Occasionally, significant lateral deviation of the spine can occur with little or no rotation of the spine and without bony abnormalities. In these cases, the scoliosis can be the result of pain, spinal cord abnormalities, tumors (both intraspinal and extraspinal) and infection.The natural history relates to the etiology and age at presentation, and usually dictates the treatment. However, it is the patient’s history, physical examination and radiographs that are critical in the initial evaluation of scoliosis and in determining which patients need additional evaluation and consideration.