PURPOSE: We aimed to investigate difference of gait variables when females wear different heel design (i.e., wide and narrow) of high heel (HH) shoes and flat shoes. METHODS: Fifteen healthy females, who used to wear HH shoes regularly, were participated. Forty-three retro-reflective markers were placed on the specific anatomic landmarks of all the subjects. We used a three dimensional motion analyzer (Qualisys Oqus, Sweden) to collect retro-reflective markers' motions. All subjects were instructed to wear HH shoes which were 9.8cm height, 7.70cm2 for wide one, and 1.44cm2 for narrow one and to walk through force plate at cadence of 96 steps/min for at least three trials. RESULTS: At stance phase, the HH group showed significantly increased joint angles of hip flexion, knee flexion and ankle plantar flexion. At swing phase, the HH group had significantly increased ankle plantar flexion angle, but decreased knee flexion angle. In contrast to the flat shoes group, at heel contact phase, the HH group had more vertical and posterior directed ground reaction force. At stance phase, the HH group had significantly increased knee moments of medial and extension sides and ankle moment of plantar flexion side. For the HH group, ankle power showed significantly decreased generation power at pre-swing phase. However, there is less difference of gait variables between the wide and narrow HH groups. CONCLUSIONS: The HH group used bigger backward force at heel contact phase; this may increase the risk of slipping. Increase knee extensor and valgus moment at stance phase, may increase the accidence of accumulative musculoskeletal injuries around knee joint. At pre-swing phase, a decrease in forward force and generation power demonstrate the inefficiency of walking while push-off for forward while wearing high heel shoe.