Reintroduce and describe a previously reported osteotomy indicated for correction of transverse plane deformities of the central metatarsophalangeal joints (MTPJs). The author has coined this osteotomy the central metatarsal distal transpositional osteotomy. It has also been reported eponymously as the Bouché/McAlister osteotomy, named after 2 podiatrists who independently further refined and popularized this procedure (Chad Seidenstricker, DPM, August 2018, personal communication). The author discusses how this osteotomy can be used in concert with soft tissue repair and other bone procedures to address various transverse and sagittal plane pathologies of the central MTPJs.