AbstractGarment alteration is a practical technique to adapt an existing garment to fit a target body shape. Typically executed by skilled tailors, this process involves a series of strategic fabric operations—removing or adding material—to achieve the desired fit on a target body. We propose an innovative approach to automate this process by computing a set of practically feasible modifications that adapt an existing garment to fit a different body shape. We first assess the garment's fit on a reference body; then, we replicate this fit on the target by deriving a set of pattern modifications via a linear program. We compute these alterations by employing an iterative process that alternates between global geometric optimization and physical simulation. Our method utilizes geometry‐based simulation of woven fabric's anisotropic behavior, accounts for tailoring details like seam matching, and incorporates elements such as darts or gussets. We validate our technique by producing digital and physical garments, demonstrating practical and achievable alterations.