The rare case of an osteoid osteoma in the distal phalanx of the 2nd toe resulting in painful enlargement and hypertrophy of the entire toe in a 12-year-old girl is discussed. The tumour was excised and the oversize of the toe was corrected by exarticulation of the distal phalanx. 18 months postoperatively the patient demonstrates normal function of her forefoot without complaints or signs of inflammation.