Paediatric flat feet are a serious therapeutic problem. During the child’s development, the foot is subject to the processes of anatomical and physiological modifications. In small children, the flat foot is a physiological variant. The assessment of the flat foot deformity is based on clinical examination, a podoscope examination and possibly radiological evaluation. Only from the age of about 3 years is it possible to consider the implementation of treatment, initially conservative with rehabilitation and possibly orthotics. Some patients require treatment with analgesics, anti-inflammatory drugs or physiotherapy due to the pain they experience, especially in the hindfoot. The lack of progress in conservative treatment requires consideration of surgical treatment, which must be individually adjusted. Arthroereisis, possibly combined with the elongation of the Achilles tendon, is the most commonly used treatment. In fixed deformities or congenital flat feet, corrective bone procedures are also performed, usually combined with soft tissue procedures.