This was a prospective study on the association of brace compliance and curve progression in idiopathic scoliosis. Compliance was measured electronically by embedding a temperature sensor and logger in the Wilmington scoliosis brace. To date there have been no studies that relate objective measures of compliance in a scoliosis brace to treatment outcomes. Thirty-four subjects with idiopathic scoliosis were monitored over the duration of their brace wear. Compliance data were downloaded and analyzed. The compliance rate for the patients whose curve progressed (>5 degrees) was 62%; the compliance rate for the patients who did not progress was 85% (P = 0.004). In the group that had high compliance (>90%), one of the nine subjects' curves progressed (11%). In the group with low compliance (<90%), 14 of the 25 subjects' curves progressed (56%, P = 0.0075). Results indicate that the more patients comply with brace treatment, the better their chances of a favorable outcome.