There is no consensus on the definition of a mirror foot anomaly. Some authors argue that it refers to a mirror image of a foot exhibiting polydactyly, while others suggest that it should involve mirror duplication of all skeletal elements of the foot extending in the tibial direction. Radiographic examinations are important for a better understanding of the preoperative anatomy and for surgical planning. Treatment of polydactyly is usually indicated for psychological and cosmetic reasons and to improve function. There is no consensus on the surgical management of this rare deformity. The patient, a five-year-old boy, presented to our outpatient clinic with the complaint of an extra toe on the left foot (Fig. 1). The patient did not have any accompanying anomalies. He had no history of previous operations or chronic diseases. According to the anamnesis obtained from the patient and his relatives, there was no family history of polydactyly or mirror foot anomaly. On physical examination, both lower extremities were of equal length, and no discrepancies were noted. Movement at the level of the hip, knee, and ankle joints was normal in both lower extremities. Examination of the left foot revealed two extra toes on the tibial side, while the other toes were normal. A radiological examination of both legs was performed to exclude associated tibial deformities. No pathology was observed in the right foot on radiographic examination. In the left foot, seven toes were fully developed along with the metatarsal bones (Fig. 2). A diagnosis of polydactyly (mirror foot) was made based on clinical and radiological findings. During the outpatient clinic evaluation, it was understood that the patient presented primarily due to cosmetic concerns, and an operation plan was formulated after detailed assessment. To excise the extra toes on the left foot, bilateral fasciocutaneous flaps were elevated along the perioperatively determined incision line to reach the tarsometatarsal (TMT) joint. Two digits and two metatarsal bones were excised en bloc from the TMT joint level. The skin flaps were revised to prevent linear scarring. The patient's limb functions were normal in the early postoperative period. He was discharged on the third postoperative day and was followed up clinically and radiologically in the outpatient clinic. The total operative time was 2 hours. The main intraoperative challenges included ensuring adequate vascularization of the skin flaps and achieving precise alignment of the remaining structures to preserve functionality. No functional decline was observed during postoperative follow-up. The skin flaps were found to have adapted safely, and the family expressed satisfaction with the cosmetic outcome (Fig. 3). Written informed consent for publication of the clinical details and images in this case report was obtained from the patient's legal guardians. Discussion Polydactyly is a congenital anomaly whose etiology remains poorly understood. The anomaly known as mirror foot is rare and typically described as an isolated defect. Its association with tibial agenesis and fibular dimelia is extremely uncommon. It may occur as an isolated genetic defect or in association with other congenital anomalies such as syndactyly, anorectal anomalies, cleft lip and palate, and cardiac defects. It can appear in both the hands and feet. Temtamy and McKusick classified polydactyly according to the location of the extra digit as preaxial, central, or postaxial. The mirror foot anomaly, regarded as a rare variant of preaxial polydactyly, is characterized by a mirror image duplication of the foot. Patients may present during childhood or later in adulthood, often due to cosmetic concerns or discomfort when wearing shoes. The definition of this variant of polydactyly remains controversial. According to some authors, the definition of mirror foot consists only of mirror-image polydactyly, whereas others argue that all skeletal elements of the foot must be duplicated in the form of a mirror image. Our case involved a five-year-old patient with a mirror foot anomaly who presented due to functional and cosmetic concerns of his family and fit more closely with the second definition above. However, given his age, this patient can be considered a late presentation. So much so that the patient had spent the last two years wearing only slippers and similar footwear on his deformed foot. Conclusion Mirror foot anomaly is an extremely rare condition and represents an extreme form within the preaxial polydactyly spectrum. Very few cases of this anomaly have been reported in the literature, and there is no consensus on the most appropriate surgical technique. Surgery should be planned on a case-by-case basis according to the age of presentation and the type of deformity, which can vary widely.