The taylor spatial frame is a unique external fixator. We evaluated the effectiveness of the Taylor spatial frame in the treatment of various deformities in children and adolescents. All but one patient were anatomically corrected. We asked whether normal alignment can be achieved with accuracy during correction of deformities around the knee and tibia while avoiding major complications in children and young adults. We prospectively reviewed the clinical and radiographic records of 16 patients (20 limbs), ages 6 to 18 years, who underwent a TSF for Distal femoral and tibial deformities. Etiology included a number of diagnoses of the pediatric age. Mean follow-up was 4 months (range, 1–18 months). The mean time in frame was 5.8 months (range, 2–11 months). Frontal and sagittal plane deformities were corrected to within normal values. The frame was used dynamically to correct all deformity for a mean time of 4.85 weeks (range, 2–11weeks). Our Deformities were reduced from a mean of 25° (range from 10-60°) preoperatively to a mean of 3° (range from 1-7°)at the latest follow up. The mean lengthening was 2.8 cm (range from 1.5-5cm).The complications included pin tractinfection, knee stiffness, delayed union, and presence of Residual deformities. Despite many challenging problems, our results compared favorably with the results achieved by others. We believe that the Taylor spatial frame is a very capable and accurate fixator for the precise correction of complex deformities.