Sprengel's deformity is a congenital structural abnormality of the shoulder girdle, and most patients with Sprengel's deformity receive surgical treatment as a child or adolescent. Thus, it is uncommon to identify an adult with untreated Sprengel's deformity. Two adult patients who had no previous surgical treatment were treated with resection of an omovertebral bone and resection of the superomedial border of the scapula. This procedure was not overly invasive or technically demanding. In both patients resection of the omovertebral bone provided an improved cosmetic appearance and reduction in neck pain, although shoulder motion was improved in only one patient. Because the patient with a long omovertebral bone adjacent to the levator scapulae muscle showed great improvement in her shoulder motion, the size, shape, and position of the omovertebral bone may predict improvement of shoulder motion after resection. Thus, the surgical treatment of adults patients with Sprengel's deformity can produce good surgical results.