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Background: Hemispherotomy is a procedure that can be used to treat cases of epilepsy that exhaust all other treatments. One of the side effects of the procedure can be spastic hemiplegia. For people with spastic hemiplegia, movement requires more effort. One intervention that has shown promise for decreasing the effort of movement is an orthotic. The purpose of this case report is to describe the process of choosing an orthotic for a pediatric patient with spastic hemiplegia following hemispherotomy. Case Description: The individual in this case report is a 10-year-old boy who underwent a hemispherotomy for pharmaco-resistant epilepsy. His resulting spastic hemiplegia created difficulty with movement so he and his mother presented for a physical therapy evaluation to determine if an orthotic would be beneficial for him. Intervention: An interdisciplinary team involving the individual and his mother, physical therapists, an orthopedic specialist, and an orthotist determined the best orthotic for the individual. The physical therapist made their recommendations based on best-available evidence, association fact sheets, and available manufacturer choosing guides and manuals. Outcome Measures: The outcome measures selected to evaluate the efficacy of the intervention were the Dynamic Gait Index (DGI), individual report, and gait observation. Discussion: The evidence and choosing guides produced similar recommendations for this individual. Qualitative results show a positive impact following beginning using the ankle-foot-orthoses (AFO). Measurable outcome measures did not show a significant change one day after receiving the AFO.