INTRODUCTION: vitamin D deficiency can result in osteoporosis and fractures (broken bones). Other disorders can develop as a result of severe vitamin D deficiency. It may result in rickets in youngsters. The rare condition of rickets makes the bones brittle and prone to breaking. Vitamin D is obtained from food and solar exposure. Vitamin D insufficiency is often not a problem for adults. Some people are more susceptible to the illness than others, particularly people with dark complexion and seniors over 65. Most folks don't exhibit any symptoms. A significant deficiency may result in bones that are thin, brittle, or malformed.Patient History:-Patient 14-year-old male admitted to the hospital, Informant is the mother. The patient was alright 12 and half years back when he had a history of fever followed by weakness in both lower limbs. The patient went to the private hospital where he was managed conservatively and advised surgery due to money issues patient came to the hospital for further management. In 2016 he was diagnosed with a metabolic disorder and deformity at the knee joint was managed conservatively then the patient was again admitted in 2017 and managed with ORIF with osteotomy with plating followed by cast application on 03/04/17. Now patient present with deformity in both knees and unable to walk for the last 3 months. Post operatively patient was walking on his own but for the last 3 months, he was unable to bear weight to walk. The patient can stand with support Presenting Complaints and Investigation: The patient 14-year-old male admitted to the hospital with a complaint of deformity in both knees since 12 and a half yearUnable to walk since 3 months, Hb-12.4, MCHV-33.9, MCV-86.7, MCH-29.4, Total RBC Count-4.22, Total Platelet Count-2.27, HCT- 36.6, Monocytes-03, T3-1.02, T4-9.89, TSH-7.73 Past History: Underwent investigations and was given medications at the private hospital, and in 2017 for deformity at both knee, he was managed with open reduction and internal fixation with osteotomy followed by cast application, Milestone is delayed. The main diagnosis, therapeutic intervention, and outcome: All examination and investigation doctors diagnosed vitamin D-resistant rickets, with hypothyroidism and growth hormone deficiency with treatment inj. growth hormone 2IU od Subcutaneous, tab.levothyroxine 50 mg 0d in morning,tab.limcee od,syp.calcimax-p 5mlbd, KCIT solution bd,syp mvbc 5mlbd, vitamin d3 sachet one's week. Conclusion: Preventive measures targeted at lowering the vitamin D shortfall in pediatric age could be taken in response to these findings.