Arthroscopy of the first metatarsophalangeal joint (MTP-1) has become indispensable method of surgical care to injuries and their consequences and damages that affect the MTP-1 joint. The advantages of arthroscopy of the 1st MTP joint in comparison to classical open surgery are multiple. Primarily, arthroscopy allows an excellent view of intra-articular structures and thus a detailed overview of the entire joint which enables us to perform complete surgery without opening the joint. Furthermore, morbidity is significantly smaller, rehabilitation is faster, and return to daily activities is also faster. Basic requirements for successful application of arthroscopy of the MTP-1 joint are careful planning of the procedure, very good knowledge of regional anatomy, strictly following the rules of performing the procedure, and an experienced surgeon with arthroscopy skills. Primary indications for the arthroscopy of the MTP-1 joint include early stages of hallux rigidus, osteochondral lesions, synovitis, and pathological conditions of sesamoid bones. In this article we describe the indications, technique, complications and the prospect of the arthroscopy of the MTP-1 joint, with a detailed overview of contemporary literature data.