Thoracolumbar kyphosis types show many variations. According to the rigidity of the deformity, it may be postural or structural. Postural kyphosis which is mainly caused by poor posture can be corrected with exercises to strengthen the back muscles to improve posture. Structural kyphosis refers to deformities that does not correct with the change of posture due to abnormalities within the structure of the spine. Those abnormalities may be congenital as fused vertebra, idiopathic like Scheuermann’s disease or acquired as malunited fractured vertebra and degenerative changes of spine segments. Those structural types require different strategy for management according to the cause and degree of the deformity. In cases where the conservative treatment is not indicated, spinal osteotomies are the way to correct the deformities. Putting in consideration that the thoracolumbar kyphosis can be classified according to the shape of the deformity into global rounded as in Scheurmann’s disease, degenerative lumbar spine and Ankylosing Spondylitis or sharp angular as in congenital and posttraumatic kyphosis, there are many types of osteotomies to deal with each pattern of deformity as: Smith-Peterson osteotomy, transpedicular decancellation, pedicle subtraction osteotomy and vertebral column resection