STUDY DESIGN: This is a retrospective study. OBJECTIVES: The purpose of the study was to determine the efficacy of pedicle screw fixation in treatment of congenital scoliosis. SUMMARY OF BACKGROUND DATA: Surgical correction of rigid congenital scoliosis often ends up in less than satisfactory results. Pedicle screw fixation, enabling a rigid fixation with improved holding power may enhance the correction of these tenacious deformities. METHODS: Twenty one congenital scoliosis treated by combined anterior release and posterior correction were analyzed after minimum follow up of 2 years (range 2-9 years). There were 11 males and 10 females. The mean age was 21.1 years (range: 11.2-29.4 years). They were divided into two groups by the posterior fixation method used. The group treated by multiple hook fixation (HF) comprised 11 patients with an index curve of 67+/-2 0degree. The group by multiple pedicle screw fixation (SF) comprised 10 patients with an index curve of 61+/-26degree. There was no statistical difference in the preoperative index curve characteristics between the two groups. RESULTS: Immediately after the surgery, the mean index curve was 37.0degreein the HF group and 29.9degreein the SF group showing a correction of 44.7+/-19% and 49+/-17% respectively. At the final follow up, the curve was 46.9degreein the HF group and 32.3degreein the SF group showing a loss of correction of 21+/-22% and 7+/-2% respectively. CONCLUSIONS: Pedicle screw fixation is an effective method of treating congenital scoliosis, offering an improved correction and maintenance.