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Objective To evaluate the short-term effects of anterior distal tibial semi-epiphyseal block surgery in treating sagittal plantar flexion deformity in children with equinovarus foot. Methods A retrospective analysis of the data of children with equinovarus foot treated with anterior distal tibial semi-epiphyseal block at Hunan Children's Hospital from February 2018 to March 2022. The preoperative and intraoperative angles of ankle dorsiflexion and anterior distal tibial angle (ADTA) on lateral X-rays were recorded, along with the occurrence of complications. Results A total of 5 cases (7 feet) were included, all male, with an average age of 10 years and 4 months (range:7 years and 11 months to 12 years and 4 months). The average duration of internal fixation was 26.2 months (range: 15 to 36 months). All 5 cases achieved a plantigrade foot. The preoperative AD-TA was (87.43 ±3.15), and the ADTA at the time of internal fixation removal was (72.43 ± 5.56)°, with a statistically significant difference (P<0.05); the preoperative ankle dorsiflexion was (15.00±14.72), and at the time of internal fixation removal, it was (14.29 ±8.86), also with a statistically significant difference (P<0.05). One case experienced screw loosening, but no cases had complications such as internal fixation fracture, infection, ankle subluxation, or bridge formation. Conclusions Anterior distal tibial semi-epiphyseal block surgery demonstrates good short-term efficacy in treating sagittal plantar flexion deformity in children with equinovarus foot. [ABSTRACT FROM AUTHOR]