Synovial osteochondromatosis is an uncommon lesion in the metatarsophalangeal joint of the great toe. The condition is usually monoarticular, involving a large joint. Common locations include the knee, elbow, shoulder, hip and ankle. The histopathology is one of apparent cartilaginous bodies. Since these cartilage cells often display nuclear atypism, an accurate diagnosis is essential to avoid the erroneous diagnosis of chondrosarcoma. A case of synovial osteochondromatosis as it occurs in the metatarsophalangeal joint is presented, and this condition is discussed with a review of the literature.