Background: Clubfoot is a relatively common congenital foot deformity. Ponseti demonstrated correction of clubfoot in infants using manipulation followed by application of well-molded, long-leg plaster casts. Objective: In the current study, we evaluated the efficacy and safety of percutaneous Achilles tenotomy as an office procedure during the Ponseti technique in the correction of CTEV deformity of the foot. Patients and Methods: This randomized clinical trial study was conducted in the Orthopedic Outpatient Clinic of Zagazig University Hospitals on 12 patients with idiopathic clubfoot managed with the Ponseti technique during the period from April 2020 to September 2020. Results: This study showed, 13 feet had a favorable outcome (8 cases (53.3%) excellent and 5 cases good 33.3%) and 2 feet had fair outcome (13.3); these 2 feet had a relapse (13.3%), one foot relapsed equinus deformity and one adducts foot deformity, The equinus deformity patient responded to repeated tendo-Achilles tenotomy and further Ponseti casting and adductus foot deformity responded to adductor tenotomy and cast. Both two cases obtained satisfactory outcomes after the completion of treatment. Conclusion: Achilles tenotomy as an out-patient procedure using topical and/or local anesthesia is a safe procedure and is an important step in the successful treatment of congenital clubfoot.