Background: The Ponseti method is a widely accepted treatment for clubfoot. This study aimed to evaluate the role of age and Pirani score in the management of clubfoot using the Ponseti method.Methods: A prospective hospital-based study was conducted on 35 patients with idiopathic clubfoot treated using the Ponseti method. The patients were assessed based on age at presentation and initial Pirani score. The primary outcomes were the number of casts required for correction, duration of treatment, and final Pirani score.Results: The mean age at presentation was 1.8 ± 1.2 months, with 83% of patients presenting before 2 months of age. The mean initial Pirani score was 4.84 ± 1.46. The mean number of casts required for correction was 6.2 ± 1.4. The mean final Pirani score was 0.13, showing a significant improvement from the initial score (p<0.001). Patients presenting before 2 months of age had better outcomes, with a mean final Pirani score of 0.14 compared to 0.1 in the 3-4 months age group and 0 in the 5-6 months age group.Conclusion: The Ponseti method is an effective treatment for clubfoot, with better outcomes observed in patients presenting at a younger age. The Pirani score is a useful tool for assessing the severity of clubfoot and monitoring treatment progress