Objective Retrospective analysis of treatment of hallux valgus combined with metatarsal adduction with scarf united Weil operation and minimally invasive osteotomy. Method From January 2015 to December 2018, 69 patients hallux valgus combined with metatarsal adduction, 37 cases (42 feet) treated with scarf combined with modified Weil operation (scarf osteotomy group), 32 cases (38 feet) treated with minimally invasive osteotomy (minimally invasive group). Before and after operation, Visual Analogue Score（VAS）, American Orthopaedic Foot＆ Ankle Society Score(AOFAS), hallux valgus angle(HVA), intermeta tarsal angle(IMA),metatarsus adductus angle(MMA) were observed. Results ① there was no significant difference between the two groups in gender, age, lateral type, hallux valgus classification, combined disease and other baseline data (P > 0.05) . ② 3 months after operation, the VAS score and AOFAS score of patients in scarf osteotomy group were better than those in minimally invasive group the difference was statistically significant (P < 0.05). ③ there was no significant difference in HVA angle between the two groups (P > 0.05), but IMA and MMA were better than scarf osteotomy group (P < 0.01). Conclusion The scarf and modified Weil in the correction of hallux valgus combined with metatarsal adduction is not only convenient for hallux valgus, but also could partially correct metatarsal adduction, and avoid the occurrence of metastatic metatarsal pain, the clinical effect is significantly better than minimally invasive osteotomy.