Osteoid osteomas account for approximately 3% to 10% of primary bone tumors and are found most commonly in the cortical, diaphyseal regions of long tubular bones. These osteoblastic, benign tumors are usually seen in males, in the second to third decade, most often in the long bones of the lower extremity. The literature describes the limited encounters with osteoid osteomas of the pedal digital phalanx, especially in the pediatric population. Here, a case report details a juvenile patient with an osteoid osteoma tumor of the distal phalanx in the right second digit that was treated with complete distal phalanx excision in toto, eliminating the patient's pain and symptoms quickly after surgery. Further the literature is reviewed for other examples of this pathology in the similar clinical setting.