Objective To explore the clinical effect of modified Chevron osteotomy on the distal end of the first metatarsal bone in the treatment of moderate to severe hallux valgus. Methods Fifty patients with moderate to severe hallux valgus from January 2019 to January 2021were selected. All patients underwent modified Chevron osteotomy at the distal end of the first metatarsal bone. The clinical and imaging results were evaluated. Results The average operation time was (50.25±18.39) min, the bleeding volume was (45.81±12.05) mL, and the surgical incisions were all healed at first stage. All patients were followed up completely, with an average follow-up of (8.12±2.10) months. The ankle joint function score (AOFAS) was significantly higher at the third and last follow-up after surgery than before, and the visual analog pain score (VAS) was significantly lower than before surgery, (P<0.05). During the last follow-up, 4 cases complained of decreased movement of the metatarsophalangeal joint of the thumb and toe, and 1 case complained of internal fixation discomfort; The valgus angle (HVA), the first and second metatarsal angles (IMA), and the distal metatarsal joint angle (DMAA) were significantly lower 3 months after surgery and at the last follow-up (P<0.05). Imaging examination showed that all osteotomy sites healed, with an average healing time of (10.86 ± 2.24) weeks. Conclusion The modified Chevron osteotomy of the distal end of the first metatarsal bone for the treatment of moderate to severe hallux valgus has a satisfactory short-term effect and is a relatively reliable treatment method.