Macrodystrophy is an asymmetrical enlargement of one or more toes that involves various histological components including the bones of the foot. This deformity can have significant effects on foot function, including abnormal gait, shoe wear limitations, and changes in the adjacent toes due to compression of the megalodon. Barsky distinguishes between two separate types of megalodontia: type I, in which the toe is large at birth and increases in proportion to the rest of the foot with age, and type II, in which the growth of the megalodon is faster than normal and the fibrofatty tissue grows significantly. A typical megaltoe is an enlargement of all components of the toe and can involve both the metatarsal portion and the toe. Pseudomegaly is associated with neurofibromatosis, multiple hemangiomas, and lipomatous dystrophy. It often presents as a giant, stiff, painful, and deformed toe. Klippel-Trenaunay-weber syndrome is a structural, terminal distribution of multiple hemangiomas. There are 3 forms: regional giant malformations, hemangiomas, and varicose veins. The disease occurs preferably ventrally (metatarsal) and extends to the lumbar region. Partial hypertrophy is more common and is associated with skin damage that appears in wine-colored erythema. The disease is progressive and difficult to treat. Treatment of megalodontia: Surgery is generally limited to reducing the size and controlling the overgrowth of soft tissue. The circumference of the toe is usually reduced by stepwise thinning. Skeletal procedures include epiphyseal stem fixation, pedicle resection, joint fusion of the proximal or distal interphalangeal joint, and column resection. Surgery includes soft tissue reduction, epiphyseal block, toe amputation, and nerve dissection and reanastomosis. If the 3rd or 4th toe is involved, amputation of one toe is possible, and amputation of the 3rd toe is an option for syndesmosis of the 2nd to 4th toe. If the 2nd toe is a giant toe, removal of the 2nd toe may cause bunion deformity and should be done with caution. Typical cases