In all severe hallux valgus deformities there is a basic metatarsus primus varus which varied from 9 to 13 degrees (in our series). Transverse metatarsal osteotomy is performed to overcome the varus deviation of the first metatarsal. Correction of the hallux valgus is accomplished by plastic repair of the capsuloperiosteal flap. Failure to correct the congenital metatarsal deformity predisposes to recurrence of the "bunion". Excessive shortening of the metatarsal shaft is occasionally responsible for postoperative symptoms of the metatarsal arch. The operation is adaptable to all degrees of deformity. The technique is relatively simple, and the results are uniformly good.