This issue will explore a variety of topics concerning the hallux and first ray exclusive of hallux valgus. A large portion will focus on hallux rigidus, including etiology, pathomechanics, nonoperative management, and various surgical techniques. Other chapters will address iatrogenic problems, including osteonecrosis, malunion and shortening of the first metatarsal, and nerve disorders of the hallux. Additional topics include hallux varus, sesamoid disorders, and arthroscopy of the first metatarsophalangeal joint. The invited authors are international experts who will review the relevant pathophysiology, treatment options, and clinical outcomes in order to guide the surgeon to appropriately manage patients with these challenging problems.