Chronic foot dermatitis can be disabling and footwear allergy is not always excluded as a cause, partly because patch testing to shoes and their components can be daunting. Once the diagnosis of shoe allergy is made, the difficult problem of finding suitable footwear remains. There is a lack of literature regarding the follow-up of these patients. We analysed the data on 55 patients with allergic contact dermatitis from their shoes and followed them up to see whether knowledge of the allergen had enabled them to find suitable footwear and to improve their dermatitis. The files of 55 patients with shoe allergy were analysed and 48 were followed up. Rubber was the commonest allergen, followed by chromate, p-tertiary-butylphenol-formaldehyde resin and colophony. All parts of the feet were affected, except the interdigital areas. The majority of patients suffered from hyperhidrosis. 43% were atopics, who had a super-added shoe allergy. The mean duration of the foot dermatitis before patch testing was 4 years 8 months. Follow-up of 48 cases showed that 87.5% had either improved or resolved completely. Most of our patients were successful in finding suitable footwear and many differing strategies were used. All patients with foot dermatitis which does not respond to treatment should be patch tested to exclude shoe allergy.