Background & Aim: Iatrogenic paraplegia during Spine surgery is a devastating complication. Preventing such complications is important. (IOM) serves to help such patients/surgeons with successful surgeries and better post-op outcome using the IOM modalities.Methods & Materials/Patients: A retrospective data review was done on 153 consecutive patients. Somatosensory- Evoked-Potentials (SSEPs), Transcranial-Motor-Evoked-Potentials (TcMEPs), Electromyograms (EMGs) & Triggered-Electromyograms (TEMGs/screw stimulation) were studied.Results: 153 patients (n=104 females, n=49 males) with average age of 17 years and cob-angle ranged between 40-140 degrees were studied. TcMEP changes were noticed in n=56, 36.6%.TcMEP change resulting from surgical maneuvers n=43, 28.10%. TcMEP changes resulted from direct injury to the cord n=16, 10.45% & mechanical intervention (decompression/hemivertebrectomy/correction) n=15, 9.80%. Mal-positioned screws n=12, 7.83%. Within this group n=9, 5.8% presented with both SSEP and TcMEP changes. Changes in TcMEP, due to anesthesia n=10, 6.53%. EMG irritation lasting>15 seconds in lumbar roots, n=14, 9.15%. Within this group, TcMEP drop noticed in 4 patients suggesting 25% predictability were observed. TEMG changes in n=81, 52.9%, where in n=42, 27.4% screws were<6mA.TcMEP change, n=12, 7.83%, all fell under this group of screws below 6mA.3018 screws were placed in 153 patients with 19.73 screws/ patient.89 scre ws, 2.94% fell under dangerous/severe category.Conclusion: Our data showed that enhanced safety with comprehensive IOM in deformity surgeries, hence IOM was extremely important during such procedures.