Hallux valgus, frequently accompanied by a medial forefoot prominence often referred to as a bunion, is a common entity seen in orthopedics. This deformity is more common in women and can frequently be familial. Patients frequently complain of difficulty wearing shoes, pain medially at the first metatarsphalangeal (MTP) joint, and cosmetic concerns over the appearance of their great toe. Simplistically, the deformity consists of lateral deviation of the proximal and distal phalanx with medial deviation of the first metatarsal. However, there is a complex interaction between several soft tissue structures that lead to the formation and progression of this deformity. Treatment initially involves nonoperative modalities such as wearing wider shoes to accommodate the deformity, toe spacers between the first and second toes, and other orthotics for symptomatic relief. Operative management is reserved for cases where symptoms are unbearable despite nonoperative measures and frequently include a combination of soft tissue releases and osteotomies. There are a variety of osteotomies available and the selection of osteotomy technique is largely dependent upon the magnitude of the deformity and the surgeon preference. Furthermore, many elderly patients with hallux valgus present with arthritis of the first MTP joint and in these cases an arthrodesis can relieve pain and correct the deformity.