Clubfoot is one of the most common congenital deformities since time immemorial. The ultimate aim of this study is to know whether Pirani severity score will allow the surgeon to give more specific answers of the questions of parents or not during the early stages of Ponseti treatment. A total number of 100 feet in 64 patients of CTEV were studied and rated according to pirani score prospectively at Guru Govind Singh hospital, M.P.Shah medical college, Jamnagar, during the period from July 2014 to July 2016 by ponseti method. The need for a tenotomy can be predicted at the onset of the treatment from Pirani severity score system. The early the age at beginning of treatment doesn’t exclude need for tenotomy. The number of cast can be predicted at the onset of the treatment from Pirani severity score system.