Freiberg's disease usually affects the second and, less commonly, the third metatarsal heads [Helal and Gibb in Foot Ankle 8(2):94-102, 1987]. It was mainly observed unilaterally in adolescent females (F/M: 3/1-4/1) (Hay and Smith in The Foot 2:176-178, 1992). Bilateral occurrence and adjacent metatarsal involvement has been previously reported separately [Maresca et al. in Arthroscopy 12(1):103-108, 1996; Rafee et al. in Foot Ankle Surg 12:153-155, 2006]. The cases presented here involve two female patients aged 42 and 72 with bilateral Freiberg's disease in both the second and third metatarsal heads. To our knowledge, this is the first report of such involvement of both the second and third metatarsal heads.