Background <p>Legg-Calve-Perthes Disease (LCPD) is described as idiopathic avascular osteonecrosis of the capital femoral epiphysis in pediatrics. LCPD is usually present in children between 2 and 15 years and happens more frequently in boys more than girls; this study aims to compare the outcome of two surgical methods in treating LCPD.</p> Methods <p>We included sixty patients with unilateral LCPD who underwent Salter or femoral varus osteotomy from 2007 to 2017. Patients were followed up for at least five years. Patients’ claudication, pain, leg circumference, range of motion, lever arm ratio (LAR), neck shaft angle (NSA), migration index, vertical distance, and the presence of teardrop sign, sagging rope sign, and Trendelenburg sign were evaluated five years after surgery.</p> Results <p>The mean neck shaft angle, the lever arm ratio, migration index and, sagging rope sign incidence in patients undergoing femoral varus osteotomy were significantly lower than those undergoing Salter surgery; the thigh circumference was higher in patients undergoing femoral varus osteotomy than those undergoing Salter osteotomy.</p> Conclusion <p>There were significant differences in biomechanical indices of hip and acetabulofemoral in salter and femoral varus osteotomy; the results of the current study are highly suggestive of prioritizing femoral varus osteotomy to Salter surgery.</p>