Objective To evaluate the role and value of Changhai fulcrum bending radiograph (CH-FBR) in curve flexibility assessment of patients with skeletal mature idiopathic scoliosis. Methods Twenty-five thoracic and lumbar vertebrae curves derived from 19 patients with skeletal mature idiopathic scoliosis treated in Changhai Hospital of Second Military Medical University between Jun. 2013 and Feb. 2015 using Changhai fulcrum bending radiographic technique were enrolled. The patients included 15 females and 4 males, with an average age of (23.1±3.5) years old (ranged from 20 to 30 years old). The assessment of radiographs included preoperative standing posterior-anterior radiograph, Changhai fulcrum bending radiograph (starting fulcrum bending, maximum fulcrum bending), supine side-bending radiograph, traditional fulcrum bending radiograph and postoperative standing posterior-anterior radiograph one week after surgery. Paired t-test was used to assess the differences between preoperative and postoperative parameters, and the correlation between parameters was analyzed by Pearson correlation analysis. Results There were a total of 25 curves in this study, including 17 thoracic curves and 8 thoracolumbar/lunbar curves. Cobb's angles in supine side-bending, traditional fulcrum bending and Changhai starting fulcrum bending were significantly different from the Cobb's angles in postoperative standing posterior-anterior (all P<0.05); Cobb's angles in traditional fulcrum bending and Changhai maximum fulcrum bending were significantly different from the Cobb's angle in Changhai starting fulcrum bending (P<0.05). The results of 17 thoracic and 8 thoracolumbar/lunbar curves were same as 25 curves. Correlation analysis of 25 curves showed that the flexibility rates in Changhai starting fulcrum bending and Changhai maximum fulcrum bending were both positively related to correction rate (r=0.84, 0.87; both P<0.01). The height of Changhai maximum fulcrum bending radiograph was positively correlated with the maximum weight (r=0.67, P=0.001), and the height changes of Changhai maximum fulcrum bending radiograph was positively correlated with the weight changes (r=0.60, P=0.001). Conclusion Changhai fulcrum bending radiograph is more reliable and effective than traditional fulcrum bending radiograph and supine side-bending for curve flexibility evaluation in patients with skeletal mature idiopathic scoliosis. Compared with the traditional fulcrum bending radiograph and side-bending radiograph, the flexibility suggested by the Changhai fulcrum bending radiograph is closer to the postoperative result made by pedicle screws fixation and fusion.