Introduction- Current demand of CTEV treatment is to have a plantigrade, supple foot in minimum possible time. Ponseti method, involving serial casting and tenotomy, nowadays appears to be sub serving these aims with best possible outcomes. This present study aims at evaluating children treated with Ponseti technique of treatment and early predictors of recurrence in such cases. Methodology- A combined prospective and retrospective study of 192 patients with 292 clubfeet was conducted. Children with established recurrence and atypical cases of clubfoot were excluded. Assessment was done for development of recurrence of deformity with the help of Pirani score, dorsiflexion and external rotation. Dynamic supination component was also studied in all patients. Results- Out of the 192 patients included in this study, 100 were bilateral (52 percent) and 92 were unilateral (48 percent). The number of cast required for achieving correction varied from 4 to 20 casts however less than 3 year of age group without any previous surgical intervention were corrected in <6 casts. 14 out of 154 (9%) idiopathic non operated patients developed recurrence in terms of lateral border on an average duration of 2 year follow up. Eight out of 20 (40%) syndromic cases and 5 out of 14(35 %) operated cases showed recurrence collectively. The foot abduction was found to be reduced in children who presented with recurrence. In many children external rotation restriction was seen before actual equinus happens. Conclusion- Ponseti’s treatment is considered the gold standard for management of idiopathic clubfoot, however recurrences are known to occur even in the best possible situations. Most of the early recurrences can be managed with repeat casting
