Forefoot injuries constitute a significant portion of the problems that affect runners. With the increasing popularity of recreational running, more emphasis on the treatment of specific running injuries has surfaced. For the orthopaedic surgeon interested in treating runners, a thorough understanding of foot anatomy, biomechanics, shoes, orthotics, running surfaces, and conservative and surgical treatment options is mandatory. Runners place high demands on their feet and therefore require careful evaluation prior to embarking on a specific treatment course. This article represents a current overview of common problems affecting the forefoot of recreational and world-class runners. Treatment plans are based on the senior author's experience in the care of runners over the past 14 years.