This report discussed an unusual case of a 23 year old woman with a painful bipartite medial cuneiform, (BMC) and severe arthritic and cystic changes at the partition with no history of trauma. MRI taken confirmed a large cyst with subchondral erosions at the dorsal and plantar segments with significant bone marrow edema. Definitive treatment consisted of arthrodesis on the dorsal and plantar segments using one lag screw, demineralized bone matrix grafting, and a bone stimulator.