Accessory ossicles of the foot are not uncommon finding in foot radiographs which has confused radiologists and
orthopedic surgeons from time immemorial. Occasionally these bones are symptomatic, hindering daily activities of
patients. We present a case report of an eleven years old girl with a symptomatic accessory medial cuneiform on the
dorsal aspect of left foot. The child was evaluated radiologically and after a trial of failed conservative treatment, she
was operated upon. Intraoperatively a superficial nerve on dorsum of this accessory ossicle was found, and the extra
bone was excised. This accessory bone was found to be related to medial cuneiform bone at its dorsal and distal surface
making to suggest its name as "Os cuneo-I metatarsale-I dorsale". Detailed radiological evaluation is mandatory for
identification and exact anatomical localization of the extra bone before proceeding to excision, when non operative
treatment fails to relieve the symptoms.