Summary Oligodactyly is a rare congenital condition caused by improper differentiation of the apical ectodermal ridge during 1st trimester of pregnancy that presents with absence of one or more toes. Diagnosis is made with the absence of one or more toes, most commonly on the lateral aspect of the foot. Treatment is observation. Epidemiology Incidence less common than polydactyly Anatomic location lateral rays are affected more often than the hallux Etiology Pathophysiology pathoanatomy due to improper differentiation of the apical ectodermal ridge during 1st trimester of pregnancy thought to be caused by teratogenic insults impaired blood flow amniotic bands Genetics positive family history in some cases sporadic in others Associated conditions orthopaedic fibular hemimelia tarsal coalition hand & foot abnormalities polydactyly syndactyly constriction rings brachdactyly medical associated with a number of syndromes including VACTERL Fanconi Presentation Physical exam absent digits Symptoms usually painless may present with discomfort during shoe wear Imaging Radiographs recommended views AP of the foot Treatment Nonoperative observation alone indications mainstay of treatment as there is usually no limitation in function