Forty patients with idiopathic clubfoot were randomized to receive Achilles tenotomy in either an outpatient clinic (OPC; n=20) or an operating room (OR; n=20). Outcomes of interest included procedural duration, infant-mother separation time, and intraoperative bleeding, which were assessed at the time of the procedure. Ankle dorsiflexion, parental anxiety, surgeon satisfaction, and the mean number of casts were also assessed at one-year follow-up. Overall, the results of the study revealed that both settings produced comparable clinical outcomes in terms of ankle dorsiflexion and parental anxiety. However, the OPC setting had a significantly shorter procedural duration and less infant-mother separation time. The findings suggest that Achilles tenotomy in an OPC under local anesthesia is a safe, efficient alternative to performing the procedure in an OR under general anesthesia.