Metatarsal shortening is not a common condition, with a reported prevalence of 1/1820-1/4568 and a higher prevalence in women of 1:25. The cause is not clear and may be due to congenital factors, growth arrest or acquired trauma. The indications for treatment include pain, metastatic metatarsalgia, difficulty wearing shoes, and functional impairment. Of course, many patients also come to the clinic with a request for cosmetic changes. Surgical treatment generally involves minimally invasive osteotomy of the metatarsal bone, external fixation with a brace, and adjustment of the brace for metatarsal lengthening about 7 days after surgery, 0.25 mm at a time, 3-4 times a day. The only scars left in the end are the external fixation pinhole and the linear scar formed by stretching. Preoperative orthopantomogram shows the shortening of the first metatarsal bone, osteotomy of the first metatarsal bone, and external fixation of the brace.