We report a patient with stroke presenting with great toe hyperextension and loss of ambulation following selective tibial nerve neurotomy. A 50-year-old woman developed double hemiparesis and dysarthria following two attacks of cerebral infarction on September 23 and October 3, 1996. After rehabilitation treatment, she became ambulant indoors with an ankle foot orthosis. About 11 months post stroke, walking became increasingly difficult due to exaggerated spasticity and consequent equinovarus and claw toe deformities on the right side. She underwent selective tibial nerve neurotomy in February 1999, and although these deformities were improved, prominent hyperextension of her great toe appeared after about 2 weeks postoperatively. Because of severe pain accompanying the deformity and misfit of the orthosis, she became unable to stand and progressively more dependent in activities of daily living. Four years after the neurotomy, she was referred to us in August 2003. On supported standing, marked hyperextension of her great toe and equinovarus deformities appeared on the right side, and we performed phenol motor point blocks on the extensor hallucis longus (EHL), flexor digitorum longus and tibialis posterior to reduce their overactivity. The deformities were improved and she was able to practice walking with a brace again.