The present study investigated the prevalence of an os peroneum (OP, a sesamoid bone) in a cadaveric sample and its relationship to the shape of the cuboid tuberosity, and cartilage degeneration at the cuboid tuberosity and in regional joints within the foot (first metatarsophalangeal and calcaneocuboid) and ankle. The fibularis longus tendon of 33 embalmed human cadavers (mean age 81 years) were obtained from the anatomy laboratory. Nineteen of 64 tendons (30%) displayed an OP both radiographically and histologically. The os peronei ranged in size from small spicules to prominent masses: mean area 2.48 mm(2) (left) and 2.70 mm(2) (right). Histologically, the os peronei were cancellous bone, the largest occupying most of the tendon at the point of contact with the cuboid tuberosity. Fibrocartilage was present at their borders, merging with dense regular fibrous tissue and peritenon. The talocrural, calcaneocuboid, and first metatarsophalangeal joints were examined for cartilage integrity and osteophytes based on an earlier suggestion that there may be an association between degenerative joint disease and endochondral bone formation. There was no statistical correlation between presence of an OP with any of the following parameters: age, gender, body size, cartilage degeneration, or osteophytes within any of the joints examined. Therefore, the presence of an OP does not appear to be associated with increased endochondral ossification or degenerative joint disease. This study does not preclude the possibility that sesamoid bone formation may be associated with biomechanical functions within the foot; thus, future studies may be warranted.