Purpose The purpose of this study was to evaluate the clinical and radiographic outcomes of modified pedicle subtraction osteotomy (mPSO) for thoracolumbar post-tubercular kypho-sis in pediatric patients.Methods From January 2008 to August 2012,26 consecutive pediatric patients with thoracolumbar post-tubercular kypho-sis underwent modified pedicle subtraction osteotomy (mPSO).The clinical and radiologic outcomes were analyzed preoperatively,postoperatively,and at the last follow-up.Results Twenty-six patients with thoracolumbar post-tubercular kyphosis underwent mPSO.The average operation time was 256 min (188~314 min).The mean follow-up was 41 months (18~56 months).The mean estimated blood loss was 870 ml (620~1020 ml).The thoracolumbar kyphotic an-gle ranged from 51 ° to 79° before operation,60.6° in average.The mean thoracolumbar kyphotic Cobb angle was 19.7° after operation,with a mean correction of 40.9°.The C7 sagittal plumb line was 3.8 cm after operation,comparing to the 10.5 cm preoperative.The mean preoperative angle of thorac-ic kyphosis (TK) was 9.9°± 1.2° and increased to 11.8°± 1.4°,postoperatively.Lumbar lordosis (LL) improved from-22.8° ±4.9° preoperative to-17.8°±2.1 ° postoperative.Visual ana-logue scale (VAS) was 8.7±1.1 preoperative and 1.2±0.4 postoperative,respectively.The mean Oswestry Disability In-dex (ODI) improved from 49.2±5.3 before surgery to 10.8± 3.3 postoperative (P<0.01).All patients received good bone healing,no significant loss of correction angle.Most patients (24/26) considered pain and exterior was significantly improved.Conclusion Modified pedicle subtraction osteotomy (mPSO) is effective and reliable for thoracolumbar post-tubercular ky-phosis in pediatric patients.