Osteoid osteoma should be considered as a potential diagnosis in cases of chronic midfoot pain in younger individuals. If proper precautions are taken, percutaneous radiofrequency ablation may be considered a safe and efficient alternative to surgical resection in the treatment of osteoid osteomas, even in the small bones of the midfoot. We report on 2 cases of osteoid osteoma, 1 in the lateral cuneiform, and the other at the base of the second metatarsal, that were successfully treated with percutaneous radiofrequency ablation. Preoperative imaging studies, procedure technique, and clinical outcome are presented. (C) 2011 by the American College of Foot and Ankle Surgeons. All rights reserved.