In-toeing commonly occurs in the pediatric population, and children with an in-toed gait pattern are often referred for orthotic management. Treatment decisions in these cases can be influenced by many factors,including the cause of in-toeing, the symptoms, the age of the child, and concerns of the caregivers. Orthotists must take each of these factors into account along with the available published evidence and their clinical expertise when formulating and implementing a plan of care.