This study proposes an innovative method for designing screw trajectories in treating slipped capital femoral epiphysis SCFE using 3D CT imaging and a hybrid of greedy and genetic algorithms. Bone features from 78 pediatric SCFE patients were segmented, and a preliminary screw trajectory was designed using a greedy algorithm. An evaluation index, guided by Beijing Jishuitan Hospital specialists, was established and optimized with genetic algorithms. The results align with current literature and show promise in enhancing surgical efficiency, marking a significant advancement in SCFE treatment.