Introduction Elite alpine skiers frequently adjust insoles, boots and skis to optimize skiing performance. There are numerous different constructions of custom made insoles. However, nobody has, to the authors’ knowledge, investigated the mechanisms behind a plausible performance increase. The purpose of the study was therefore to investigate the potential difference in pressure distribution under the feet when skiing with regular insoles compared to custom made insoles. Method A pre-study investigated differently constructed insoles and their possible effects on the pressure distribution under the feet. One test subject performed different squat and fly-wheel exercises with six differently constructed insoles. Kinetics and 3D-kinematics were collected to identify possible differences. One insole construction, with a flat bottom and a semi-soft upper layer, was thereafter chosen to be used for field tests. Nine professional skiers, including both race skiers and full time ski instructors, were recruited for the field tests. Each skier performed in a randomized order, three runs with a standard insole and three runs with a custom made insole. Plantar pressure under the feet was measured with the Pedar Mobile System at 100 Hz, for eight consecutive carving turns. The skiers were instructed to have the smallest possible time difference between all runs. The three runs for each situation were synchronized and the mean total, forefoot and midfoot pressure distributions were calculated. Results The pre-study results show that the pressure distribution between foot and insole and between insole and ski-boot depends on the insole construction. The mean time for all 54 runs was 26.62 ± 2.41 s and the mean individual time difference between the fastest and the slowest runs was 0.62 ± 0.33 s. All skiers showed large individual differences in percentage of “used” area under the feet, between the two types of insoles (5-80%). When skiing with the custom made insole, the total mean difference in percentage usage of the forefoot was -17 ± 19% and 8 ± 12% for the midfoot. Discussion The results show that the pressure distribution under the feet depends on the type of insole. However, the effect of a custom made insole is very individual. Hence, when performing studies of skiing kinetics and/or equipment, it is of vast importance that all subjects use similarly constructed custom made insoles. It can also be hypothesized that e.g., different canting angles of the ski-boot, affect the skier differently depending on the type of insole. Our suggestion is therefore to perform measurements to optimize the insoles before investigating and optimizing canting angles. The results also show that custom made insoles can assist the skier to utilize different areas of the foot. However, future studies are needed to investigate whether the decreased usage of the forefoot affects the overall aggressiveness of the setup and whether custom made insoles have a positive effect on skiing performance.