Pronation of the foot is one of the commonest reasons for prescribing orthotics for the lower extremity. Many different bracing systems are available for the management of this complex problem. To select the most efficient method for a given case, the healthcare professional and the orthotist must have a firm understanding of the pathophysiology of pronation and the special requirements of each patient. Additionally, the medical condition resulting in pronation and necessitating bracing may alter after the selection of the orthoses. Selection of cases for treatment depends on the type, because pronatory deformities can be grouped according to markers that are cause specific. The use of orthotic therapy as a modifier of the natural history in simple pronation remains controversial.