Management of severe adolescent Blount disease is challenging. However, there is a consensus in the literature that early diagnosis and early aggressive surgical treatment are mandatory for a successful treatment and to prevent the progression of the deformity and the development of depression of the medial tibial plateau. Aim: to assess the clinical and radiological results of acute surgical correction of severe adolescent Blount disease by single stage double level corrective osteotomy with elevation of the depressed medial tibial plateau using internal fixation. Subjects and Methods: The current prospective study included 20 patients (24 limbs) suffering from severe adolescent Blount disease treated by acute medial tibial plateau elevation, intra-epiphyseal, osteotomy together with another proximal tibial metaphyseal osteotomy to correct the rest of the deformity (remaining varus, internal tibial rotation and procurvatum) using internal fixation implant in the form of proximal tibial locked plate (4.5 mm LCP) applied medially with the aid of cannulated screws for plateau elevation. Results: The mean pre-operative MTPDA was 31.6°, the mean post-operative MTPDA was 4.95°. The mean pre-operative FTA was 32.75°of varus, the mean post-operative FTA was 2.75° of valgus. The mean pre-operative FC-T angle was 60.5°, the mean post-operative FC-T angle was 92.12°. All of these changes in the radiographic parameters pre and post-operatively were statistically significant (p-value < 0.0001). Clinical assessment at the latest follow-up showed significant improvement of the mean thigh foot angle (TFA) from 29.45° internal rotation pre-operatively to 5.54° external rotation post-operatively, improvement of the mean clinically associated procurvatum deformity from 21.3° of procurvatum pre-operatively to 5.3° of procurvatum post-operatively and improvement of the gait pattern with disappearance of varus thrust during stance post-operatively. All patients retained their pre-operative ROM with no restriction of knee flexion or extension. Also, there was improvement of pain relative to pre-operative assessment in all patients. No significant LLD (< 1.5 cm) was noted at the latest post-operative assessment. Conclusion: The acute double level osteotomy technique described in the current study for treating patients with severe adolescent Blount disease is considered a technically demanding procedure. Despite these technical difficulties, it gave satisfactory results in terms of restoration of articular surface congruence, correction of the complex multiplanar deformity of the proximal tibia and minimizing or preventing the future recurrence with low incidence of complications, gradual correction by Ilizarov may be reserved for morbidly obese Blount cases with severe deformity to minimize any risk for intra-operative vascular compromise or deformity undercorrection