<p>Percutaneous epiphysiodesis using transphyseal screws (PETS) is a well-established method for managing limb deformities and length discrepancies in growing children. This technical report presents a modified approach to PETS. It emphasizes the use of a retrograde guidewire for precise screw trajectory and an antegrade screw placement technique. The procedure is performed under fluoroscopic guidance without a tourniquet, allowing immediate post-operative weight bearing. Key steps include meticulous patient positioning, fluoroscopic imaging to ensure accurate screw placement, and careful attention to anatomical landmarks. This technique offers advantages, such as minimal blood loss, shorter operative times, and preservation of joint function. By detailing our approach, we aim to enhance surgical efficiency and facilitate broader adoption of this minimally invasive procedure in orthopedic practice.</p>