As a variably occurring sesamoid, the hallucal interphalangeal sesamoid can significantly alter the biomechanics of the great toe. With modifications to the way the great toe functions, there are pathologies that inevitably arise. These pathologies can be quite serious and debilitating. While clinicians may take a conservative approach to treatment and focus on alleviating the symptoms, the physically active patient who desires to return to competitive participation may benefit most by having the source of the pathology removed altogether. The following is a report of an athlete who returned to competition six weeks after surgical excision of the anomalous hallucal interphalangeal sesamoid.