Tibial sesamoidectomy is frequently the treatment of choice for different tibial sesamoid pathologies when non-surgical treatment fails. However, surgery is not without postoperative complications, such as hallux abducto valgus (HAV) deformity. Currently, there is a paucity of research regarding isolated tibial sesamoidectomy and its complications. The purpose of this paper is to present two cases of isolated tibial sesamoidectomy, a brief description of surgical technique, an anatomic and functional description of hallux sesamoids, and an updated literature review on isolated tibial sesamoidectomy.