Flat feet are common in children. Loss of the medial arch may be due to intrinsic or extrinsic abnormalities of the foot. Physical evaluation usually suffices to identify the various growth stages which modify alignment and joint mobility, thus affecting foot function. Flat feet not caused by intrinsic structural abnormalities are right considered benign since they only exceptionally cause discomfort in adulthood. Shoe inserts provide only improved comfort during walking. Surgery is used in the extremely small proportion of patients with severe arch loss or deformities secondary to another condition.