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Radiography showed the bony tips of his right second and third toes had been eroded away. Acquired acro-osteolysis in the surfer\u2019s toes resulted from increased blood flow initiated to repair microdamage caused by repeated trauma to the distal ends of his second and third right toes due to the habitual dragging of the affected toes across a surfboard. The always initial lytic phase of bone repair was magnified by the increased arterial input to warm the extremities after prolonged exposure to cold. At 6-years\u2019 follow-up, the use of a protective bandage while surfing has permitted full regeneration of the affected toes. 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