The major mission of Toms is that a business, rather than a charity, would help their impact last longer. In his speech at the Second Annual Clinton Global Initiative Mycoskie states that his initial motivation was a disease called podoconiosis—a debilitating and disfiguring disease which causes one's feet to swell along with many other health implications. Also known as "Mossy Foot", podoconiosis is a form of elephantiasis that affects the lymphatic system of the lower legs. The disease is a soil-transmitted disease caused by walking in silica-rich soil. Toms currently works with factories nearby where they perform some of their shoe drops.
Shoes have been given to children in 70 countries worldwide, including the United States, Argentina, Ethiopia, Rwanda, Swaziland, Guatemala, Haiti and South Africa. Toms are sold at more than 500 stores nationwide and internationally, including Neiman Marcus, Nordstrom, and Whole Foods Market, which include shoes made from recycled materials.