Objective To explore the influence of Scarf combined with Akin surgery on efficacy, bone metabolism and postoperative complications of hallux valgus.Methods A total of 104 patients with hallux valgus (150 feet) who came to the hospital for treatment were selected between April 2018 and February 2020, and they were divided into observation group (52 cases, 73 feet) and control group (52 cases, 73 feet) by using the random number table method. Control group was given Chevron combined with Akin osteotomy treatment, and observation group was given Scarf combined with Akin osteotomy treatment，and the two groups of patients were followed up. The pain status (visual analogue score, VAS), serum bone metabolism ［procollagen I type N-terminal peptide (PINP), β cross-linked C-telopeptide of type I collagen (β-CTX), osteocalcin (OC)］, walking status ［Functional Ambulation Category Scale (FAC), Berg Balance Scale (BBS)］, imaging indicators ［hallux valgus angle (HVA), intermentatarsal angle (IMA) of first and second metatarsals, distal metatarsal articular angle (DMAA)］ and treatment effect ［American Orthopedic Foot and Ankle Society (AOFAS)］ were compared between the two groups of patients before surgery and at 12 months after surgery. The occurrence of postoperative complications were recorded in the two groups. Results There were no statistically significant differences in VAS score, BBS score, AOFAS score, serum bone metabolism indicators (PINP, β-CTX, OC)，imaging indicators (HVA，IMA，DMAA)，pain degree，FAC walking ability classification and foot function evaluation between the two groups (all P>0.05). A t 12 months after surgery，the VAS score, serum PINP level and DMAA value in the two groups were significantly lower than those before surgery (all P<0.05), while the level of serum β-CTX and AOFAS score were significantly higher than those before surgery (all P<0.05)，and the evaluation of pain degree， FAC walking ability classification and foot function evaluation were significantly improved compared with those before surgery (all P<0.05), but there was no statistical significance between the groups (all P>0.05). BBS score at 12 months after surgery was significantly increased compared to before surgery (all P<0.05) while HVA and IMA were significantly decreased compared to before surgery (all P<0.05), and the differences between the two groups were statistically significant (all P<0.05). There were no statistical differences in the incidence rates of postoperative complications such as postoperative hallux varus，metatarsophalangeal joint movement limitation，insufficient correction and recurrence between the two groups (P>0.05).Conclusion Scarf combined with Akin osteotomy and Chevron combined with Akin osteotomy both have good therapeutic effect on patients with hallux valgus, and the former one is more effective in improving HVA angle, IMA angle and postoperative balance ability of patients.