The most common complaints of patients with tarsal-metatarsal arthritis are severe loss of function and painful ambulation. In cases of failed conservative management, the recommended treatment is arthrodesis of the affected joint(s). This article presents a report of three cases of fourth-fifth metatarsocuboid arthritis treated with a fourth-fifth metatarsocuboid interposition alarthroplasty. Follow-up evaluation of all three patients demonstrated satisfactory pain relief. No postoperative complications were noted in any of the patients. Although more study is needed to evaluate the use of fourth-fifth metatarsocuboid tendon interpositional arthroplasty, the procedure offers promise and a suitable alternative to arthrodesis.