For a cost-utility analysis-based study, the goal was to compare the cost-utility of bracing against observation in thoracic scoliosis patients who would benefit from bracing. According to high-quality evidence, bracing can reduce the radiographic advancement of spine curvature in adolescent idiopathic scoliosis (AIS) patients with curves between 25° and 40° and a Risser 0 to 2 skeletal maturity index. However, the cost-utility of bracing in AIS was determined to the researcher’s knowledge. A decision-analysis model comparing bracing vs. observation was built for a hypothetical 10-year-old girl (Risser 0, Sanders 3) with a 35° significant thoracic curve. Based on a thorough literature assessment, the researchers calculated each node’s probability, cost, and quality-adjusted life-years (QALY). The Consumer Price Index was used to adjust charges for inflation, and the results were published in 2020 real dollars. The incremental net monetary benefit (INMB) was computed using Monte Carlo simulations of 1,000 hypothetical patients and probabilistic sensitivity analysis. Various cost, probability, and QALY estimations were used in 1 way sensitivity studies. At the $50,000/QALY willingness to pay level, the researcher’s decision-analysis model found bracing was the preferred treatment over observation. Bracing was linked to reduced net lifetime expenses ($60,377±$5,340 with bracing vs $85,279±$4,543 with observation) and greater net lifetime QALYs (24.1±2.0 with bracing vs 23.9±1.8 with observation) in a simulation study of a hypothetical patient cohort. Bracing was linked to an INMB of $36,093 (95% CI $18,894–$55,963) throughout the patient’s lifetime. The model was susceptible to bracing versus observation on the likelihood of requiring surgery as an adolescent or an adult. According to a cost-utility study, scoliosis bracing was the preferred treatment option for adequately recommended AIS individuals with thoracic scoliosis.