Objective The purpose of the present study is to evaluate the incidence of complications following traditional dual growing rods combined with apical control techniques (TDGR + ACT) and identify the potential risk factors.Methods The patients with for early-onset scoliosis (EOS) treated with TDGR + ACT from 2006 to 2022 were reviewed and grouped according to the occurrence of complications. Demographics, surgery-related data, radiological parameters, complications, and clinical outcomes were collected. Univariable and multivariable logistic regression analyses were performed to identify potential risk factors for complications. Receiver operating characteristic (ROC) curve analysis was used to identified the cut-off value.Results A total of 60 patients treated with TDGR + ACT were enrolled, including 28 managed with apical control pedicle screws (ACPS) and 32 with hybrid technique (HT), and the mean follow-up was 6.50 ± 3.67 years. A total of 45 complications occurred in 25 patients (41.67%). Multivariable analysis revealed that the number of lengthenings was an independent risk factor for complications (OR = 1.624, P = 0.011). The ROC analysis identified that the cut-off value of number of lengthenings was 5. The mean EOSQ-SELF emotion scores in the complication group were significantly lower than those in the non-complication group (64.20 ± 16.50 vs. 81.44 ± 18.81, P < 0.001).Conclusion The overall incidence of complications following the treatment of TDGR + ACT was 41.67%. The number of lengthenings was an independent risk factor for complications in TDGR + ACT, with a significant increase of risk when the number of lengthenings was > 5. Complications not only affect patients’ physical health but also severely impact their psychological well-being.