Background: The literature contains several techniques for calculating metatarsal adductus angle. Most common systems use the fourth metatarsal cuboid joint and the fifth metatarsal cuboid joint. Although both systems are quite different, normal values of metatarsus adductus angle have not been established with each system of measurement. Methods: Two hundred six radiographic images of feet in dorsoplantar projection were used to measure the metatarsus adductus angle using two different reference points: the joint between the fourth metatarsal and the cuboid and the joint between the fifth metatarsal and the cuboid. Results: Comparison of the results of the two measurement techniques showed significant differences (P < .05). The values of the metatarsus adductus angle also showed significant differences in men versus women (P < .05). The reliability of the measurements was checked by using an intra- and inter-evaluator test performed by two evaluators. Conclusion: Data showed the reliability of both systems of measurement, although significant differences in the metatarsal adductus angle mean value were found using these systems of measurement in the same foot. On the other hand, significant differences were found in mean values of metatarsus adductus angle between male and female feet. (J Am Podiatr Med Assoc 98(5): 364–369, 2008)