This article is intended to provide the podiatric physician with a comprehensive overview of the surgical management of metatarsus adductus deformity. Both soft tissue and osseous procedures are reviewed including a practical discussion of the preferred incisional approaches, surgical techniques, and postoperative care. Current indication and concepts for each procedure are discussed. A comprehensive history and physical exam, with emphasis on the clinical evaluation and radiographic findings, are critical aspects in the management of the patient with metatarsus adductus. Selection of procedures will be based upon this information as well as chronological age and osseous maturity. When significant deformities in the rearfoot complex are present (that is, pes valgo planus, equinus), consideration should be given to surgical correction simultaneously with correction of the forefoot deformity or at a later stage.