Objective of this study is to emphasize importance of early diagnosis and management of vitamin D deficiency, an easily manageable problem which could otherwise lead to significant morbidity for the patients and subsequent burden for the health system and to the family as well. Methods: This prospective case series was conducted in Shah Bhitai district Hospital Hyderabad, Pakistan, from March 2015 to September 2015. Children and adolescents of the age less than 18 years with clinical and radiological evidence of vitamin-D deficiency were included. All patients were given intramuscular vitamin D 600,000 IU followed by oral calcium supplements. Patients were followed with clinical and radiological response at 2 months. Data was analyzed using SPSS. Conclusion: Proper anticipation and early treatment of vitamin D deficiency is important not only to prevent developmental delay or gross skeletal deformities which take months for improvement and sometime needs surgical intervention. Results: 28 patients with clinical and radiological evidence of rickets were selected. Mean age of our patients was 0.5 – 17 years (mean 5.10 years, SD +/-4.802). Two out of 28 patients were found to have pseudofracture of proximal femur and pubic rami. At two months follow-up, 23 out of 28 patients showed clinical and radiographic improvement. 3 of our patients reported improvement in clinical symptoms but they then lost to follow-up and we could not get their radiological follow-up. 2 patients did not showed improvement in their clinical and radiographic parameters.