true size. Usually wears athletic shoes 3.5. Their feet are very flat and wide. We tried on many different pairs of shoes with low 1.5 inch heels and even the large sizes hurt her feet and she could not balance in any of the heels. So I ordered them in size 3.5W and they are perfect! She loves them and said they don't fit. won't hurt her feet like all the other pairs she's tried on and much safer for her on slippery surfaces.