bjective ：To compare Weil-metatarsophalangeal joint preservation and metatarsophalangeal joint shaping in the treatment of middle and late stage rheumatoid foot. Methods A clinical data of 36 cases of rheumatoid foot., who were admitted between July 2017 and July 2020 and met selection criteria, was retrospectively reviewed. Among them, 16 cases were treated with Weilmetatarsophalangeal joint preservation and 20 cases were treated with metatarsophalangeal joint shaping. No significant difference was found between 2 groups in gender, age, side of the affected rheumatoid foot, course of disease and preoperative visual analogue scale (VAS) score, range of motion of the affected metatarsophalangeal joint, and the American Orthopedic Foot and Ankle Society (AOFAS) scoreThe differences were not statistically significant（P>0.05）. To compare Postoperative HVA Angle, IMA Angle, VAS score, AOFAS score, flexion and Extension of metatarsophalangeal joint.X-ray film was used to check the condition of internal fixation or prosthesis in two groups .Result:The incisions of both groups healed. Weil osteotomy group was followed up for 12 to 25 months (mean 15 months) , and arthroplasty group for 12 to 29 months (mean 17 months) . Weil osteotomy group patients in hospital costs more than joint shaping group（t=2.742，P=0.011）.VAS Score, AOFAS score, flexion and Extension of the affected metatarsophalangeal joint were significantly improved at the last follow-up（P＜0.05）.The joint flexion and Extension of the Experimental Group is better than the control group. Conclusion Joint Preservation and joint shaping can provide significant improvement in pain and motivationrheumatoid foot. But, the cost of joint preservation was higher than that of joint shaping, and the flexion and extension of metatarsophalangeal joint was better than that of joint shaping group.