The cavovarus foot deformity is often the end point of muscle imbalance and usualy caused by hereditary motor sensory neuropathies. The other causes of this deformity includes cerebral palsy, cerebral injury (stroke), anterior horncell disease, talar neck injury and clubfoot sequela and burns. The relative overpower of the peroneus longus and tibialis posterior muscles cause hindfoot varus and forefoot valgus (pronation). The varus of the hindfoot causes overloading on the lateral aspect of the foot, which may later result in ankle instability, peroneal tendinitis, and stress fracture. Degenerative changes can be seen in overloaded joints. Gait examination provides valuable information for planning tendon transfers to correct stance and swing-phase disorders. Inspection of the forefoot and hindfoot positions determines the need for soft tissue release and osteotomy. The Coleman block test is essential in differentiating the causes of the hindfoot varus.The inappropiate use of orthoses or supportive footwear can result in muscle imbalance which causes increases in the deformity and brings permanent damage to tendons and joints. Tendon rebalancing is a priority in order to prevent unsalvageable deterioration of the foot. Muscle imbalance can be corrected by tendon transfer, corrective osteotomy, and fusion. Fixed bony deformities should be handled by fusion and osteotomy.