Metatarsalphalangeal (MTP) joint disorders involving the 2nd through 5th toes are not the most common injury of the ankle and foot in athletes but can be problematic if not recognized. A good history and physical examination along with weight bearing radiographs of the affected foot can identify most of these disorders. Generalized synovitis of the forefoot can occur with overuse and can result in plantar plate instability. Plantar plate injuries can be difficult to treat but surgical options do exist and continue to evolve. Freiberg disease can be likened to avascular necrosis of the hip, and should be considered specifically in the athlete with pain localized over the second MTP joint. Bunionettes typically respond well to conservative treatment in the athlete with over the counter pads and callus care;​ however, surgical options are well described based on the type with good outcomes.