Nowadays, body cast is especially used in the treatment of early onset scoliosis although it has been practiced since 19th century. Curative effect of serial body casting on early onset scoliosis was first officially emphasized in London Scoliosis Symposium in 1979. If casting could be started in the proper time, it has therapeutic effect on mild and moderate scoliosis, or has a preventive effect on the progression of severe scoliosis and delay of the surgery. In this way, it is possible to reduce the complications of early surgery. Brachial plexus injury, cranial nerve palsy, and superior mesenteric artery syndrome are the major acute complications of casting with general anesthesia. In a study, a different complication, which is about two times increased maximum inspiratory pressure during casting, was reported. Therefore, careful casting with proper technique and release of the certain parts are essential. Finally, despite of the existence of modern surgical techniques, body cast which is effective even in congenital and neuromuscular scoliosis besides early onset scoliosis as showed in recent studies, is a rational and preferable method with less complications.