Deformity surgery has been largely a sub-specialization within spinal surgery that has been traditionally both technically demanding and with great morbidity. As we have better understood the surgical goals of surgery, the end point has been elucidated but now the techniques and approaches have been re-evaluated and newer novel techniques have been adopted. The goal of this presentation is to define the current goals of deformity surgery, review traditional approaches, and present newer techniques to address spinal deformity. We will examine the current literature and look at outcomes and data to review to validity of laterally based surgery. In addition, we will present a number of cases to discuss and examine. The goal will be to be able to evaluate a patient with spinal deformity, identify the pathology, understand the goals of surgery, and consider various strategies to address the underlying problem.