This presentation discusses the orthotic management of myelomenigocele, spina bifida, and the lower limb mangement of children with muscular dystrophy. The author explores the neural tube defect, myelomenigocele, and its causes. Included in the discussion is the rate of incidence, partial or complete paralysis, and the levels of affect. Discussion ensues on the short-term and long-term ambulators, their muscle strength, quality of life, early wheelchair proponents, early walking proponents, and bracing techniques and options. Muscular dystrophy is discussed at length in terms of independent ambulation, orthotic assisted ambulation and wheelchair mobility, and contracture management.