136 pediatric patients recommended for ankle-foot orthoses were randomized to receive a device either made with standard molding and casting or with laser scanning using computer-aided design and computer-aided manufacturing (LSCAD/CAM technology). The purpose of this study was to determine if either AFO production method was associated with significant differences in production time, orthosis length of life, patient satisfaction, and cost-effectiveness. Although results demonstrated a significantly reduced amount of molding/rectification time for LSCAD/CAM orthoses, there were no differences in production time, orthosis length of life, patient satisfaction, and cost-effectiveness between the two groups.It should be noted that a significantly higher proportion of LSCAD/CAM AFOs did not meet specifications, with 17% of LSCAD/CAM AFOs being remade compared to 3% of cast AFOs.