Background Evidence suggests that the factors behind the increased risk of falls among polio survivors are mainly categorized into intrinsic and extrinsic domains. The intrinsic category involves factors like muscle weaknesses, fear of falls and self-reported balance problem. In contrast, extrinsic factors include poor environmental circumstances and ambulatory issues that cause reduced ability to adapt to walking conditions in polio patients. Therefore, the present study aimed to investigate biomechanical footwear’s effects on gait and balance in individuals with polio. Methods A total of 30 participants were randomly divided into two groups of 15 each. The experimental group received customized shoe footwear with features such as medial arch support, metatarsal pad, rear foot control, fibreglass lateral counter, and a rocker sole. The control group did not receive specialized footwear. Results The intervention group showed significant improvements in several gait parameters compared to the control group, including step length (p=0.008), stride length (p=<0.001), step width (p=0.002), cadence (p<0.001) and speed (p=0.0009). The intervention group also showed significant improvements in Berg Balance Scale scores (p=0.07) compared to the control group. Conclusion Biomechanical footwear with medial arch support, metatarsal pad, and rear foot control can improve gait and balance in individuals with polio. Keywords Disability, Gait, Foot Orthosis, Poliovirus.