The results of surgery in 59 patients with Scheuermann's kyphosis are reported at an average follow-up of 56 months. These show that in skeletally immature patients, in whom the iliac apophysis has not yet fused to the body of the ilium, posterior fusion alone is adequate and is followed by little loss of correction. For skeletally mature patients combined anterior and posterior surgery is recommended. In all cases a period of pre-operative treatment is important. It is stressed that the indications for surgery are limited.