Current management of injuries to the tarsometatarsal complex depends on the type and mechanism of the injury, the forces involved, whether the injury is high or low-energy, and whether it occurred in an athlete. Foot and ankle injuries are some of the more common injuries in athletes, with foot injuries accounting for 16% of all sports-related injuries1. Certain athletes are at higher risk. Midfoot sprains occur in 4% of football players per year, with offensive linemen incurring 29.2% of these injuries2. Tarsometatarsal injuries in athletes are distinctly different from those due to high-energy trauma. Athletes tend to have subtle clinical and radiographic findings, and a high index of suspicion is necessary to recognize and diagnose these injuries appropriately. A wide spectrum of injuries to the tarsometatarsal and associated interrelated joints is now recognized. Treatment concepts have evolved over the past decade, with use of more rigid forms of fixation and, most importantly for the athlete, intensive rehabilitation.