“Turf toe” is primarily a hyperextension injury to the hallux metatarsophalangeal (MTP) joint. It classically occurs in football players participating on artificial grass; however, it can occur in any sport, and on any surface. As turf toe is becoming more readily recognized and understood by physicians and trainers caring for athletes, we are able to identify the injury more acutely and treat it more efficiently. Through careful evaluation, we are also able to more accurately assess which patients will need surgical intervention to improve outcome. In this techniques paper, we review the entity of turf toe in the athlete with an acute injury. We also review the athlete who has experienced a “sprain” of the hallux MTP joint, yet continues to have symptoms necessitating surgical intervention. By reviewing the anatomy of the hallux MTP joint and our approach to the clinical and radiographic evaluation of the hallux MTP joint, we hope to offer guidance to treating the athlete with a turf toe injury, and, when indicated, a surgical technique for the operative repair of turf toe injury.