Objective <p>In 2017, the author first published two clinical cases demonstrating the initial safety and efficacy of a new treatment for congenital muscular torticollis in adults based on percutaneous myotomies and simultaneous fat grafting. This article aims to update the outcomes of this technique by retrospectively analyzing a total of 24 patients.</p> Materials and Methods <p>The outcomes of 24 patients with congenital muscular torticollis, with a mean age of 25 years and a minimum follow-up of 24 months, were retrospectively analyzed. Four patients were treated using percutaneous myotomies and enriched fat grafting using an enzymatical isolation protocol for obtaining stromal vascular fraction. The remaining 20 patients were treated with percutaneous myotomies and enriched fat grafting using a mechanical isolation protocol. The study assessed aesthetic and functional improvement using a modified Lee scoring system.</p> Results <p>At 24-month post-treatment, functional and aesthetic improvement was excellent or good in 83.33%, with no relapses, complications, or unwanted side effects. Postoperative MRI controls also showed absence of abnormal muscular architecture.</p> Conclusions <p>The use of percutaneous myotomies and enriched fat grafting is an effective and safe option for treating patients with congenital muscular torticollis of any age. Larger series of patients and a longer follow-up are needed to determine its definitive efficacy across all age groups and degrees of torticollis deformities.</p> Level of Evidence: IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a></p>