Background: Tarsal coalition represents a common cause of foot and ankle pain in adolescents. It is often overlooked in patient with foot and ankle pain. Talocalcaneal coalition management is still controversial. There are few long-term studies evaluating tarsal coalition resections. The purpose of this study was to assessment of early results of surgical management of symptomatic cases suffering from Tarsal Coalition Radiologically and also clinically regarding pain relief and functional outcome. Patients and methods: In this study 20 feet in 18 patients from both sexes suffering from symptomatic tarsal coalition were analysed in a retrospective cohort study, presented to Zagazig University Orthopedic Department between September 2021 till December 2022. Surgery was indicated for symptomatic tarsal coalition cases with flatfoot and heel valgus deformity, with follow up of 2 years. Results: There were 11 males 61.1% and 7 females 38.9% in the study group with average age 15 years old (between 11 - 19 years). Full history and clinical examination was done for all patients, pain assessment using VAS score, functional assessment using AOFAS score, then radiological assessment using X-rays and CT, Procedure performed was coalition excision and triple arthrodesis. Combination of coalition resection with triple arthrodesis showed statistically significant improvement in functional, radiological and foot alignment. Conclusion: Surgical treatment of symptomatic cases suffering from tarsal coalition provides good clinical and functional outcome, Triple arthrodesis found to be excellent surgical option in treatment of complicated cases of tarsal coalition with altered hindfoot biomechanics and heel valgus causing clinical improvement.