Footwear is an inseparable gear during physical activity; however, it compromises with one critical aspect of the human body: heat regulation and sweating. Thus, footwear breathability comes into question as an important factor in balancing comfort and performance, especially in a hot and humid environment. Current findings, despite still limited, have discovered negative effects from poor breathability in athletic performance across different sports. Additionally, wearing less-breathable footwear is one of the major contributing factors in increasing risk of diseases and foot-related injuries. Under such circumstances, sweat management and lack of footwear breathability is one major caveat within the shoe design, however, the pathophysiology is still academically understudied. To date, there are very little to no publications that comprehensively discuss about this topic, and findings are inconsistent across numerous perspectives, making the puzzle mostly unfinished. In contrast, the running industry has been conducting independent and/or commercial research and development programs which explores variables in shoe design related to breathability. Reflecting from it, authors discuss on the importance of conducting further academic exploration in this topic while proposing several potential studies to begin with, to bridge the gap and develop a better understanding.