OBJECTIVE: Torsional osteotomies of the femur and tibia may be indicated in select individuals with a combination of increased femoral anteversion and external tibial torsion. This study aims to quantify the presurgery and postsurgery levels of pain, function and mobility, and gait patterns in patients with lower extremity torsional abnormalities (LETAs). METHODS: Patients with LETA who underwent torsional osteotomy of the femurs and/or tibias were recruited. Before and 1 year postsurgery, participants had a gait analysis and completed patient-reported outcomes. CT torsional assessment was performed at baseline. Paired t tests and statistical parametric mapping were used to assess presurgery and postsurgery changes. RESULTS: Ten participants (18 ± 2 y) completed the study. Participants had 29 ± 10 degrees of femoral anteversion and 45 ± 11 degrees of external tibial torsion. The hip rotational arc and transmalleolar axis improved towards norms following surgery. The major deviations found in the kinematic were observed in the transverse plane, and they improved towards norms postsurgery. The patient-reported outcomes were below norm presurgery but improved significantly postsurgery. CONCLUSIONS: Results from this study suggest that LETA can be diagnosed based on radiologic, gait, and physical abnormalities. Postsurgery results showed that torsional osteotomy alleviated pain, restored physical function, and normalized gait patterns. LEVEL OF EVIDENCE: Level IV.