&NA; Neuromuscular scoliosis concerns a wide variety of disorders, all with a different approach to surgical intervention. The impact of these disorders on a patient is discussed in terms of pulmonary, cardiac, bowel and bladder function and complications in the perioperative and postoperative period such as gastric ulcers, pathologic fractures, wound healing, and nutrition is described. These difficult patients need a multidisciplinary approach. The ‘Utrecht team’ set‐up is described in an ‘as we do it’ way. Items on preoperative clinical and radiological examination are provided, as well as points of special attention in perioperative care. Early detection, decision‐making and intervention makes it possible to correct and stabilize the spine in these children with a short stay in hospital and a quick recovery.