Metatarsal lengthening can help the orthopedic surgeon correct significant linear and angular metatarsal and toe deformities that cause cosmetic or functional disabilities. Brachymetatarsia is a rare condition, which can be acquired through trauma or tumor; however, it also is associated with a long list of congenital syndromes, and genetic counseling may be indicated. Management of this condition can include activity and shoe modification, but surgical treatment can permanently correct the symptoms. Surgical treatment can vary from acute to gradual correction, and various devices are available for fixation.