The medial cuneiform, also called the first or internal cuneiform, is located around the middle foot. It is on the inner side of the foot, behind the first metatarsal (which leads to the bones of the big toe) and the in front of the navicular bone. It is shaped similarly to a wedge. Together with the first and second metatarsals, the navicular, and the intermediate cuneiform, this bone is part of joints in the mid-foot.

The medial cuneiform is the largest cuneiform in size, although all of these bones are still relatively small. The cuneiforms are situated between the metatarsal bones and the small navicular bone. The other two cuneiforms are known as the intermediate and lateral cuneiforms.

The bone functions as the attachment for numerous ligaments (fibrous connective tissue), such as those of peroneus longus and the tibialis anterior muscles. The medial cuneiform participates in articulation (joint movement) along with the first and second metatarsals, the intermediate cuneiform, and the navicular.