Alan "Nasty" Nash, 41, beat off 12 other competitors to win the seventh annual championships at Ye Olde Royal Oak Inn in Wetton, Staffordshire, on Saturday.
Mr Nash, of Stoke-on-Trent, won the event in 1994, 1996 and 1997 and described his fourth title as "absolutely fantastic".
The sport resembles arm wrestling and each player has to try to force their opponent's foot over and onto a footrest.
He and the women's event winner, 40-year-old Karen Davies from Sheffield, both won a year's supply of ice cream from American firm Ben & Jerry's, the contest's sponsors.
English win
Devised in the 1970s, organisers wanted to give England the chance to be world-beaters in at least one sporting sphere.
But dreams were soon shattered when a visiting Canadian won the inaugural event.
World Toe Wrestling Federation president George Burgess and WTWF organiser Brian Holmes have unsuccessfully applied for Olympic status, but claim they have had requests to use the format from as far away as Japan.
Brian Holmes, a member of the World Toe Wrestling Federation (WTWF), said the championships attract different people.
"We're never sure where people are going to come from. But we do get people from as far away as the next village," he said.
"We have had a Canadian, who actually won the title, but it's mainly people from the local area or walkers."
Four-time world champion Alan "Nasty" Nash has even been knighted in the West Indian island of Redonda.