Normal variations of lower limb development are a common source of parental concern and are commonly referred to paediatric orthopaedic clinics. To determine the proportion of children referred to a paediatric orthopaedic outpatients with potentially normal developmental variations, referral letters and case notes of children attending the paediatric orthopaedic clinic at our institution over three months were analysed and categorized according to the main reason for referral. The number with true orthopaedic pathology was documented. Variations of normal anatomy and physiology accounted for 53.1% of all new referrals seen at the clinic with intoeing and flexible flat feet being the commonest referrals in this category. The rate of true primary pathology was only 16.3%. Normal developmental variations form a significant proportion of all new referrals to paediatric orthopaedic clinics. These take time and resources to process. Strategies to minimise these referrals are needed.