Pes cavus is a foot deformity characterized by an excessively high medial longitudinal arch (Fig. 55.1). It is usually fixed (i.e., inflexible), meaning that it does not flatten on weight-bearing. The components of pes cavus are a varus hindfoot, plantar-flexed first metatarsal (MT), adducted forefoot, and clawed toes. It has been reported as bilateral in 8–15% of the population worldwide.