Pain in the medial aspect of the big toe is mostly due to bunions, in addition to direct traumatic causes. In women, this pain is often caused by improper shoe wear or special activities, such as dancing, ballet, etc., that cause pressure on the medial aspect of the bunion, resulting in a localized non-bacterial inflammatory lesion that causes localized pressure. In more severe cases, bunions may also occur, which are often referred to as big toes. In men, if there is no specific cause, it is most often due to gout. Although gout occurs in other joints, it is most common in the medial aspect of the big toe, often showing unprovoked nighttime pain and localized redness and swelling, and a blood uric acid test should be done to clarify the diagnosis.