A retrospective review of 37 cases of infantile tibia vara (25 patients) demonstrated a high rate of recurrence following proximal tibial and fibular osteotomy. Sixteen limbs (43%) required a single osteotomy, whereas 21 (57%) required from one to four additional osteotomies. We conclude that in patients with infantile tibia vara, massive obesity, initial osteotomy with Langenskiöld grade III or greater lesions, and initial osteotomy after 4 1/2 years of age are all associated with a high degree of recurrent deformity.