Forefoot pain is a common clinical presentation which is often debilitating for the patient. Chronic forefoot pain often impacts upon the patient’s ability to participate in paid employment. Enjoyment of simple life pleasures is also compromised as forefoot pain makes walking a dog or playing with children / grandchildren unpleasant. This paper will demonstrate a systematic approach to sonographic assessment of forefoot pain considering a wide range of differential pathologies. In particular the sonographic technique for plantar plate assessment will be demonstrated. A dynamic method for identification and differentiation of Morton’s neuroma and intermetatarsal bursitis will also be demonstrated.