Abstract: Objective To compare the clinical effectiveness of the minimally invasive Chevron and Akin osteotomy (MICA) and open Chevron osteotomy for mild-moderate hallux valgus (HV). Methods A total of 46 patients (52 feet) with mild-moderate HV from July 2017 to February 2020 were enrolled, where 24 patients underwent MICA, including 16 combined Akin osteotomy, and 28 patients received open Chevron osteotomy, including 12 combined Akin osteotomy. Both groups were compared for complications, clinical scores, and radiographic parameters. Results All patients were followed for more than two years. The MICA group presented shorter operation time and average bone healing than the open group (P<0.05). Five patients in the MICA group reported complications, including two cases of fixation irritation, one case of joint stiffness and two cases of nerve injury. Meanwhile, nine patients in the open group reported complications, including six cases of joint stiffness, two cases of hypertrophic scars, and one case of wound dehiscence. There were no statistical differences in the incidence of complications between the two groups (P>0.05). No statistical differences were found in perioperative data, radiographic parameters, and clinical outcomes before surgery (P>0.05). The orthopedic effect were stable in the two groups and there were no statistical differences in clinical scores and radiographic parameters between the groups (P>0.05). Conclusions The MICA and open Chevron osteotomy is effective for mild-moderate HV, but MICA is advantageous in reducing soft tissue complications and shortening bone healing.