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Abstract: A subtle Lisfranc ligament disruption is a rare but potentially devastating injury to the midfoot. If the injury is recognized and treated early, the patient can avoid future arthritic changes and the need for more extensive surgery. The use of bilateral weight-bearing radiographs can aid in the early detection of this subtle injury. This article describes a patient who presented to an orthopedic office with complaints of right foot pain and an inability to participate in physical activity following an intramural sports injury 3 months earlier, and was eventually diagnosed with Lisfranc injury., (Copyright © 2022 American Academy of Physician Associates.)