Clubfoot is one of the commonest congenital abnormalities and is 2–3 times commoner in African populations than Caucasian. From December 2000 in Lilongwe, Malawi, the Ponseti method was used for treatment of this condition combined with the Colombian Clubfoot Score. Over the study period 150 patients were treated, with an average age on presentation of 5.5 months. 43% of cases had completed the manipulation and casting part of treatment and 5.5 months. 43% of cases had completed the manipulation and casting part of treatment and had been braced, but 75% of these were no longer attending regular follow up. We believe that the method is useful for treating CTEV in Africa, but that the intensive nature of the therapeutic regime leads to compliance difficulties.