Summary:Metatarsocuneiform arthrodesis is one option that should be considered when treating hallux valgus in adolescents and adults with metatarsus primus varus and first-ray hypermobility. With this procedure, correction of deformity with low risk of recurrence is made possible through the use of stable internal fixation and by preserving first-ray length. In this article we describe in detail one preferred surgical technique, aftercare, and rationale for appropriate selection of patients.