We present a case of a 58-year-old female patient (Caucasian British) with Parkinson's disease. This was initially diagnosed in 1994 by a neurologist based on her clinical presentation. In 2004, she presented to the Orthopaedic surgeons with a 6 month history of right sided foot pain and loss of foot shape. The foot had been swollen but this had started to settle. Examination revealed a warm and swollen foot, abducted forefoot and a flat longitudinal arch. Radiographs taken at this time showed disruption of the tarsometatarsal joint with dorsolateral subluxation and bone fragmentation. There was also evidence of an old 2nd and 4th metatarsal fracture. A diagnosis of Tarsometatarsal Charcot Arthropathy was made. She was treated with an aircast boot to prevent further deterioration of alignment. In early 2006, the left foot also showed the early stages of Charcot Arthropathy and by the end of the year she had developed bilateral midfoot collapse. An electromyogram of the lower limbs did not show any evidence of peripheral neuropathy or L5/S1 radiculopathy and this was also confirmed with a neurology opinion. By 2008, she had unfortunately developed bilateral rocker-bottom feet despite treatment with total contact casts. She was unable to tolerate this and is currently being treated in an aircast walker.