I'm a true 8 (lengthwise) with borderline narrow and bony feet. I almost always buy 8M and get a near perfect fit, save for a little extra room widthwise. I bought the 8M in red suede and these are beautiful, with an elegant look and feel, like high end European designed shoes. For those who care to know, these do not show any toe cleavage. They are also incredibly comfortable, with no squeezing, rubbing or pinching, even after hours of wear and walking, despite the pointy toe box. They did not require any break in period. They do however, run about half a size too large on me, in length and width, but it may just be down to my slightly narrow and rather thin feet. Occasionally, my heels, especially my slightly smaller left heel, will pop out of the shoe if I walk very quickly. I tried them with insoles and they feel more snug, but I'm happy to wear them with or without the insoles as they truly are so wonderfully comfortable. I think if you're a true Medium width, these will be true to size, with perhaps a tad more wiggle room length wise, which could be due to the pointy toe design. Do note also, that the soles are slippery on polished wood and glazed ceramic tile floors but fine on pavements and other surfaces.  My sons told me they look like witch or pixie shoes but I love these so much, that I just bought another pair in black suede, in 8 (N), to see if it will be a better fit. I will update this review, once I receive them.

UPDATE - 27/6/18
I got the black suede pair in 8 Narrow, and they are freaking FLAWLESS. Comfortable beyond words, gorgeous, no pain, no blisters, no slippage. Can't believe I've lived my whole life wearing the wrong shoes (Medium width), but so glad I finally found my solemate Thank you Trotters for your incredible shoes and thank you Amazon, for making them available at an unbelievable price!