Spinal tethering surgery is witnessing shifting paradigms to more active-and-dynamic interventions. While initially used to modulate growth at a fixed point, with advancements in surgical techniques and designs of the implants, tethering allows correction to be more controllable and adaptable. There is an increasing awareness now among surgeons to preserve motion and flexibility of the spine while aiming at maximizing the growth potential with implants potentially adjustable or removable as the child matures. This dynamic control seeks to steer spinal growth in a more natural manner while reducing future complications associated with rigid fusion.