Recent discoveries in the pathogenesis of adolescent idiopathic scoliosis (AIS) indicate that various hormones, especially estrogens, have a role in its onset and development. This role for estrogen seems possible because of its interaction with factors that influence the development and progression of this spinal deformity. Additionally, estrogens impact bone remodeling and growth, as well as bone acquisition, all of which are affected in AIS. Despite the fact that estrogens are not causative factors of AIS, they could impact the progression of spinal deformity by interacting with factors that modulate bone growth, biomechanics and structure. Thus, clarifying the role of estrogens is essential for understanding how AIS evolves during skeletal growth and for the development of new therapeutic interventions.