From 1991 to 1997 we performed 20 tibialis posterior tendon-transfer operations in 17 patients with drop-foot, in 11 of peripheral neurogenic origin and in 6 because of neuromuscular disease. Postoperatively, all patients could walk without an ankle-foot orthosis. At follow-up after mean 2 (1-5) years, all patients had active dorsiflexion of the foot and toes, with a median active ankle dorsiflexion of 5 degrees (-15-10 degrees). The median active plantar flexion was 40 degrees (10-45 degrees), and the total range of movement was 40 degrees (15-50 degrees). At follow-up, the gait was good in 15 and improved in 2 of the 17 patients.