The diagnosis of a congenital talonavicular coalition is one that often may be little more than an incidental radiographic finding. However, the acute onset of vague midfoot symptomatology secondary to a minor traumatic event may reveal this rarely reported condition on further clinical examination. The authors present a description of the characteristic historical and clinical features of talonavicular coalitions, current diagnostic and treatment modalities available, and a case presentation of an acute painful talonavicular synostosis in an adolescent male athlete.