For a study, the researchers wanted to determine the effectiveness of anterior vertebral body tethering (AVBT) in patients with skeletal immaturity. Given the scarcity of data, the value of AVBT is currently unknown. Between 2012 and 2018, skeletally immature individuals with idiopathic scoliosis were treated with AVBT by 2 surgeons operating at 2 separate centers and observed for more than 2 years. Data were gathered prospectively and then augmented retrospectively as needed. Preoperatively, at the Ist erect radiograph (FE), 1 year postoperatively, and at the most recent follow-up, outcomes were measured (FU). A total of 116 primary tethering procedures were performed on 122 patients (108 thoracic and 8 lumbar tethers). Direct tethering of both lumbar and thoracic curves was found in 4 cases. The average age at surgery was (12.7 ± 1.4) years (8.2–16.7), with Risser (0.5 ± 0.9) years (0–3). The average duration of follow-up was (37 ± 9) months (15–64). The mean coronal Cobb angle of the 130 tethered curves preoperatively was (50.8° ± 10.2)(31–81), which was considerably corrected with (26.6° ± 10.1) (3–61) on the FE radiograph (P<0.001). From FE to 1-year, there was a considerable improvement, with a mean of around (23.1° ± 12.4) (-37–57) (P<0.001). Between 1-year and FU, there was a minor but significant rise from (25.7° ± 16.3) (-32–58) (P<0.001), which appeared to result in tether breaking. Slight curves that were not tethered were adjusted at FU from (31.0° ± 9.5) (3–57) to (20.3° ± 10.3) (0–52) (P< 0.001). At FU, the rib hump was changed from (14.1 ± 4.8) (0–26) to (8.8° ± 5.4) (0–22) (P<0.01). There were 28 problems in 25 patients (22%). About fifteen patients (13%) required 18 revision surgeries, with 6 fusions completed and 1 pending. In most cases, AVBT of immature issues results in good deformity repair. Complication and revision rates, on the other hand, point to the need for better implants and patient selection. Long-term follow-up is still required to determine the procedure’s true efficacy.