The authors describe a new surgical technique for the correction of metatarsus adductus using an abductory osteotomy performed in the lesser tarsal region that enables transverse plane correction of an adducted forefoot. This procedure is based on the premise that matatarsus adductus deformity is actually a deformity of the midtarsus rather than the metatarsus segment of the foot. The osteotomy technique involves shortening of the lateral column using closing wedge technique and lengthening of the medial column using opening wedge technique. The correction is entirely in the transverse plane; however, modifications may be performed when other planal deformities are present. Historical review, principles, technique, and case studies are discussed.