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Indications for surgery are failure of non-surgical treatment as well as a flexible rather than stiff arch:
*{{cite journal|last1=Vulcano|first1=Ettore|last2=Deland|first2=Jonathan T.|last3=Ellis|first3=Scott J.|title=Approach and treatment of the adult acquired flatfoot deformity|journal=Current Reviews in Musculoskeletal Medicine|volume=6|issue=4|year=2013|pages=294–303|issn=1935-973X|doi=10.1007/s12178-013-9173-z}}
*{{cite web|url=http://www.aofas.org/footcaremd/treatments/Pages/Flatfoot-Surgical-Correction.aspx|title=Flatfoot Surgical Correction|website=American Orthopaedic Foot & Ankle Society|accessdate=2018-07-04}}</ref>
</ref> In children, X-ray may be taken in more severe cases of flat feet in order to determine the extent of the deformity.<ref>{{cite web|url=https://my.clevelandclinic.org/health/diseases/14483-flatfoot-in-children/diagnosis-and-tests|title=Flatfoot in Children: Diagnosis and Tests - How is pediatric flatfoot diagnosed?|website=Cleveland Clinic|accessdate=2018-07-09}}</ref>
