The patient is a 24-year-old male with no prior trauma who presented with a 7 year history of forefoot pain placed on several over-the-counter drugs and other conservative treatments including percutaneous therapy. The patient recalled steroid injection and intralesional sclerotherapy three years prior to her admission with no relief. Physical examination demonstrated a firm mass on the plantar surface of the first intermetatarsal space (IMS) without motor nor sensory deficit. Vascular examination was unremarkable. Plain x-ray demonstrated a soft tissue widening of the 1st IMS with phleboliths. The surrounding bony structures of the forefoot were unaffected. Magnetic Resonance Imaging (MRI) demonstrated a hypo intense lesion on T1 weighted sequence taking up the plantar surface of the left foot.. There was peripheral heterogeneous enhancement after gadolinium injection. The lesion was multi-lobulated, measuring 30 × 22 mm, with intermediate intensity and contained several separations on T2 weighted and fat suppression sequences. The lesion had completely taken up the 1st IMS displacing the soft tissues of the midfoot without any signs of infiltration. The patient underwent surgery after written and informed consent was obtained. A plantar longitudinal approach across the 1st interosseous metatarsal space was undertaken. After careful dissection, an intramuscular tumor taking up the interosseous muscles was excised.. Immediate postoperative recovery was uneventful. Pathology examination of the surgical specimen demonstrated an intramuscular hemangioma without any signs of malignancy. Patient has no signs of local recurrence or functional impairment of the foot at the last follow-up, 3 years after complete excision.