Arthrodesis of an osteoarthritic second metatarsophalangeal (MTP) joint is suboptimal because of altered gait mechanics; hence, joint-preserving procedures are of value. Autograft interpositional arthroplasty is one available option with excellent results, but there are potential concerns regarding donor site morbidity and insufficiency of the autograft material. We present here an alternative technique, an interpositional arthroplasty using allograft. Our technique includes a dorsal incision and joint exposure, removal of cartilage from the metatarsal head, and interposition of human decellularized dermal allograft sutured to the metatarsal head. Allograft interpositional arthroplasty is a feasible technique and can be further investigated as an alternative procedure for patients with second MTP osteoarthritis. Level of Evidence: Level V, expert opinion.