This article describes the use of intramedullary rodding as a treatment for an anterior tibial stress fracture in a patient with high functional demands: a professional ballet dancer. In our patient, a year of conservative treatment and later tibial drilling was unsuccessful. After sustaining a complete fracture at the site of the stress fracture, he was treated with intramedullary rodding and was able to dance 21 weeks after surgery. The fracture went on to complete healing. The role of prophylactic intramedullary nailing in this difficult fracture is discussed.