【Abstract】Objective To evaluate the effectiveness of soft tissue realignment combined with Scarf osteotomy and Akin osteotomy for moderate to severe hallux valgus. Methods The clinical data of 28 patients (35 feet) diagnosised moderate to severe hallux valgus and treated by soft tissue procedures combined with Scarf osteotomy and Akin osteotomy from September 2017 to September 2019 were analyzed, retrospectively. There were 2 males (2 feet) and 26 females (33 feet) with an average age of 434 years (range, 2558 years). The disease duration was 322 years (mean, 91 years). Preoperative Xray examination showed that the hallux valgus angle (HVA) was (344±46)°and the firstsecond intermetatarsal angle (12 IMA) was (152±29)°. The American Orthopaedic Foot and Ankle Society (AOFAS) score was (497±92) and the visual analogue scale score (VAS) was (47±24) before operation. The Postoperative complications and the healing time of osteotomies were recorded. The HVA, 12 IMA were measured by Xray and the AOFAS and VAS scores were recorded at the followup of 3 and 6 months after operation, and compared with those preoperative. The patients' satisfaction was investigated by RolesMaudsley score. Results Twentyseven patients were followed for 624 months (mean, 124 months). All the surgical wounds healed by first intention, without infection or dehiscence. All the two osteotomies were unoin in one stage, and the healing time was (27±04) months. No delayed healing or nonunion occurred. At 6 months followup, the HVA and 12 IMA were (157±36) °and (61±17) °, respectively（t=13206，P=0000; t=21553，P=0000). The AOFAS and VAS scores were (908±65) and (12±11), respectively (t=12554, P=0000; t=13846, P=0000). The satisfaction survey showed that 18 patients were very satisfied and 7 patients were satisfied (926%). Conclusion The effectiveness of soft tissue realignment combined with Scarf osteotomy and Akin osteotomy for moderate to severe hallux valgus is satisfactory.