In many cases of acquired flatfoot deformity, the sagging of the joint line originates in the naviculocuneiform joint with collapse of the medial arch. Posterior tibial tendon function may or may not be preserved. The commonly held treatment option with triple or double arthrodesis fails to address the instability of the naviculocuneiform joint. To achieve a stable correction of the deformity, the authors, therefore, started to combine an arthrodesis of the subtalar joint with a fusion of the naviculocuneiform joint. In case of residual valgus malalignment after preliminary correction, a medial sliding osteotomy of the calcaneus is necessary to achieve full correction of the hindfoot. Sparing the Chopart joint may enable the foot to accommodate better to the ground while walking, particularly on uneven ground. Despite excellent short-term results, longer term outcome studies are necessary to validate the benefit of this technique.