Background/Aims Spastic paresis is the most common motor disorder in stroke survivors and can cause various types of muscle overactivity. This can lead to the development of spastic equinovarus foot, producing an inadequate base of support that limits locomotion and weight transfers. Physical therapists require better knowledge of the effects of spastic equinovarus foot in order to administer effective clinical treatment. Therefore, the aim of the present review was to describe changes in the muscle morphology and force production of stroke survivors with spastic equinovarus foot in relation to gait performance. Methods A narrative review of research into the effects of spastic paresis and equinovarus foot in stroke survivors was undertaken. Results There were a total of 20 identified studies that observed muscle-tendon morphology and force production in stroke survivors. All studies included in the present review reported several changes in muscle and tendon biomechanical properties as results of the spastic muscle overactivity. Conclusions Stroke survivors with spastic equinovarus foot experience muscle and tendon morphology that result in decreased force production, muscle power and gait performance.