Brachymetatarsia is a condition of premature closure of the epiphyseal plate of a metatarsal. The authors present a case of brachymetatarsia of the second metatarsal. Utilizing a review of the literature, various surgical procedures are discussed. Treatment in this case consisted of a metatarsal-slide lengthening osteotomy, a modification of the Giannestras step-down procedure.