There has been no earlier report in the literature on sustentaculum tali fractures in children (pediatric age). Here a pediatric case of a sustentaculum tali fracture that has not been previously reported in the literature is reported. A 9-year-old boy who presented with sustentaculum tali fracture and concomitant deltoid ligament rupture, 1 month after the injury, underwent fragment excision and reconstruction of the deltoid ligament. Radiography, computed tomography and MRI findings are discussed. This is a case report that describes the presentation and management of a comparatively rare and often miss-diagnosed fracture of sustentaculum tali in pediatric age. J Pediatir Orthop B 18:354-356 (C) 2009 Wolters Kluwer Health vertical bar Lippincoft Williams & Wilkins.