Metatarsalgia is one of the most common documented foot problems. This pain is localized to the area across the plantar forefoot, including the second through fourth metatarsal heads. It is frequently accompanied by deformity of the first and fifth toes. Although there is great variability in possible causative factors, all of them seem to be related to gait mechanics, foot anatomy, and foot and ankle deformity. An individualized treatment protocol is required. Nonsurgical management is usually sufficient to achieve satisfactory results. Surgical correction must be precise, and all painproducing deformities must be corrected.