This study evaluates the effectiveness of hemivertebra excision in children via simultaneous anterior and posterior operative exposures. This study was a retrospective review of patients treated with this technique over a 5-year period with minimum 2-year follow-up. Eighteen patients were studied, all of whom had undergone hemivertebra excision and deformity correction using unilateral compression instrumentation. The average age of the patients at the time of operation was 3 years 2 months and the average preoperative coronal curve measured 40°. There were no neurologic complications. At an average follow-up of 35 months all patients had obtained bony fusion; the average coronal curve measured 11° for an average percentage correction of 71%. Hemivertebra excision by simultaneous exposure is an effective and safe way of managing congenital hemivertebra, and the correction is similar to staged anterior-posterior procedures or posterior-only procedures.