OBJECTIVE: To evaluate the effect of a contralateral shoe-lift and ipsilateral leather outsole on the energy consumption in hemiplegic gait. METHOD: Ten hemiplegic patients who could walk independently were enrolled. Using portable ergospirometer (K4b2, Cosmed, Italy), quantitative evaluation of oxygen consumption under varying shoes conditions was done: 1) regular shoes 2) a half-inch shoe-lift on the sound side 3) a half-inch shoe-lift on the sound side and leather outsole on the plegic side. The evaluation distance was 20 meter on comfortable walking speed. RESULTS: The oxygen consumption was significantly decreased after the application of shoe-lift compared with regular shoes (p<0.01), and the oxygen consumption was least with the application of shoe-lift and leather outsole (p<0.05). This effect was prominent in subject with poor muscle power in hemiplegic lower extremity. The walking speed was also increased with shoe-lift and leather outsole (p<0.05). CONCLUSION: The results of this study demonstrate that proper shoes modification can reduce the energy consumption in hemiplegic gait and can lead to more efficient functional ambulation.