Scoliosis is a common disease in children that causes deformity of spine and thoracic cage. The deformity not only affects the appearance, but also leads to irreversible impairment of lung function and respiratory failure in severe cases. This systematic review on publications over past 50 years demonstrates that scoliosis impairs growth and development of lungs, limits chest wall movement, and results in restrictive ventilation defect and gas exchange dysfunction. Respiratory failure occurs primarily in early-onset scoliosis and/or during latter half of gestation. Surgery corrects deformity and may slow down its progression. However, invasive procedure itself impairs lung function. Non invasive procedures prevent the deterioration of lung function rather than promoting growth and development of lungs. As a consequence, reserve of pulmonary function is recommended when surgical intervention is considered.