The absence of hallucal sesamoids is an uncommon and incidental entity, bilateral absence is rare, and few cases of symptomatic patients have been reported in literature. Most patients present with metatarsalgia limited to plantar aspect of the great toe, with aggravation of pain on walking and relief at rest. We present a unique case of ipsilateral symptomatic hypoplastic medial hallucal sesamoid and asymptomatic absence of medial sesamoid at the contralateral foot.
