Tethered Cord Syndrome (TCS) is a complex neurological disorder characterized by the abnormal fixation of the spinal cord, typically at the conus, leading to a spectrum of neurological symptoms. Diagnosis of TCS involves a multifaceted approach, incorporating clinical history, physical examination, and neuroimaging modalities such as magnetic resonance imaging (MRI) to assess spinal cord morphology and tethering. Clinical manifestations may include back pain, lower extremity weakness or sensory changes, bowel and bladder dysfunction, and orthopaedic abnormalities. Surgical intervention is often indicated in symptomatic cases of TCS or when neurological deterioration is evident. The primary goal of surgery is to release the tethered spinal cord and alleviate symptoms, thereby preventing further neurological deficits. The timing of surgical intervention remains a critical aspect of the management of TCS. However, the decision for surgical intervention should be individualized, considering factors such as age, comorbidities, and overall health status. In conclusion, this abstract highlights the significance of a comprehensive diagnostic evaluation and judicious timing of surgical intervention in managing TCS. Multidisciplinary decision-making between clinicians and patients is essential to tailor treatment strategies and optimize clinical outcomes in patients with TCS.