Duplication of one or more toes may occur as an isolated anomaly (Bromley et al. 2000) or in association with other skeletal anomalies or be part of a generalized syndrome (Castilla et al. 1998). In 85 % of instances, polydactyly is an isolated anomaly, while the remaining 15 % are associated with other congenital anomalies (Castilla et al. 1998). As many as 310, clinical entities associated with polydactyly have been identified, and 80 mutations in 90 genes have been implicated in the causation of syndromes with this anomaly (Biesecker 2011). This emphasizes the need for the clinician to be aware that a newborn infant with polydactyly must be evaluated to exclude the more serious of the numerous syndromes associated with this seemingly trivial anomaly. The location, number, pattern, and symmetry of the duplicated toes may help in differentiating some of these conditions.