75 adult patients suffering from hallux valgus with an increased intermetatarsal angle were randomly allocated to undergo proximal opening wedge osteotomy with wedge-plate fixation or proximal chevron osteotomy of the first metatarsal. This trial aimed to compare clinical and radiographic results of both procedures using the American Orthopaedic Foot & Ankle Society scores, the SF-36 mental and physical scores, VAS pain, activity score, satisfaction score, and radiographic outcomes. Findings indicated comparable clinical and radiographic outcomes. Proximal opening wedge osteotomy lengthened, while proximal chevron osteotomy shortened the first metatarsal.