55 patients undergoing hammertoe surgery were randomized to undergo one of the following procedures: proximal interphalangeal joint (PIPJ) resection or PIPJ fusion. The purpose of this study was to compare the effectiveness of the two techniques using the American Orthopaedic Foot & Ankle Society scale, the Foot Function Index, and the visual analogue scale pain scores up to one year postoperatively. Radiographic outcomes such as sagittal and anteroposterior toe alignment were also assessed. Findings indicated that PIPJ resection and PIPJ fusion techniques were comparable in all clinical outcomes. Sagittal toe alignment was more improved in the PIPJ fusion group compared to the PIPJ resection group; anteroposterior toe alignment was similar between groups.