Until recent years, hallux valgus did not exist in Japan. Changing customs and styles of footwear during the past ten years have led to an increasing number of patients with the classic hallux valgus deformity. These are not mild deformities, but are painful and require surgical correction. The ratio of the width to the length of the foot is similar in both sexes and was measured in children up to the age of 14. Coincidentally, at about that time students may freely wear any type of fashionable shoe. We conclude, therefore, that the hallux valgus deformities we are now seeing with greater frequency are caused, at least in part, by the change in footwear.