The pediatric spine has special criteria ; it is growing structure, malleable, adaptable, and changes its contour. It may involve in many deformities. The deformed pediatric spine represents a great challenge for spine surgeons. The treatment options are observation, conservative, or operative. Observation and conservative management usually do not give satisfactory results in progressive deformities and surgical intervention is then indicated. If definitive surgery (fusion of the spine) is performed it will led to many problems like, trunk limbs disproportionate, crankshaft phenomen. So growth rods; which based on internal fixation of the spine in good alignment with preserved spine growth by periodically distracting rods. It is technique based on upper and lower constructs placement, end fusion, and subfacial rod placement. Then the rod is distracted periodically with deformities progression or trunk growth. The main drawback of this method is repeated surgeries and the usual complication of posterior instrumentation can also occur. It is one of few available methods and gives promising results with many authors.