A 14-year-old boy was diagnosed with mixed phenotype acute leukemia and underwent 28 months of chemotherapy with vincristine and methotrexate. Early in his chemotherapy treatment, he developed hyperalgesia of his feet and ankles, particularly on the left side, believed to be due to the vincristine. Despite medical treatment, he continued to have hyperalgesia and increasing left foot deformity and pain that markedly affected his walking. He presented for orthopaedic evaluation at the end of his chemotherapy and had foot deformities that were corrected surgically with substantial improvement in his foot position and walking ability. He remains in remission for his leukemia. The effects of chemotherapy-induced peripheral neuropathy on the lower extremities are reviewed.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSJOPA/A203).