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Meningomyelocele is a congenital defect resulting from the incomplete closure of the neural tube during embryonic development, making it the most common structural birth anomaly of the central nervous system. Over time, these deformities can progress to the knee and ankle joints due to the development of contractures. In addition, rotational deformities of the lower extremities are also seen. This study outlines a mid-childhood female with a complaint of fixed knee flexion and a spastic equinovarus deformity that has been affecting her walking and performing activities of daily living for the past 8 years. She had a history of operated meningomyelocele closure surgery and subsequent ventriculoperitoneal shunt surgery for hydrocephalus in situ at the age of 1 year old. Preoperative physiotherapy management was prescribed to educate, rehabilitate and minimise complications associated with postoperative rehabilitation and to minimise dependency for daily living activities, which will further improve quality of life.