Background: Three dimensional club foot deformities do not respond equally to corrective manipulation. Surgery is offered to those who fail to respond to conservative treatment with manipulation and Plaster of Paris (POP) casting. Patients and Methods: We performed this procedure in a small group of 23 feet (12 patients) where equinus deformity could not be corrected by manipulation. Results: Good or excellent results were achieved in 78 % of the patients. This was achieved without complications and increase in morbidity. Function and appearance was better or comparable to patients treated by other methods. The study shows efficacy of complete subcutaneous tenotomy of the Achilles tendon in the management of resistant club feet treated with POP casts. Conclusion: We recommend early subcutaneous tenotomy of the Achilles tendon for resistant equinus element of the club foot deformity after the forefoot adduction and hind foot varus have been successfully treated.