Tarsal navicular stress fractures present a difficult diagnostic and treatment dilemma for the orthopedic physician of an active individual. Patients often complain of diffuse, poorly-defined symptoms and have a paucity of physical findings. Initial diagnostic evaluation often. fails to recognize navicular stress fractures which results in delayed diagnosis and treatment. A bone scan is sensitive in detecting this entity and the clinician should use this examination in any patient who is suspected of having a navicular stress fracture. After a navicular stress fracture is confirmed, a CT scan is required to identify the extent of the fracture. The progression of navicular stress fractures is fairly predictable; treatment can be tailored based on the needs of the individual as well as the stage of presentation. Nonsurgical and surgical options are effective treatments for this disorder.