Osteoid osteoma is a benign tumor which most commonly affects adolescents and young adults. Although this lesion occurs predominantly in the lower extremities, it has been described in the great toe only once before in medical literature. This bone lesion causes acute localized pain, worse at night, and it is relieved by aspirin or other anti-inflammatory medications. Treatment of choice is en bloc excision of the lesion. The prognosis with appropriate diagnosis and treatment is excellent.