Aims: To compare the results of Kellerñs excision arthroplasty with those of distal osteotomy for hallux valgus in patients less than 55 years of age. Patients and Methods: 20 consecutive patients less than 55 years of age with hallux valgus who had undergone unilateral Kellerñs excision arthroplasty were individually matched for age and sex with 20 patients who had undergone distal metatarsal osteotomy. The patients were reviewed for the purpose of this study. The review process included self assessment using foot function index, Hallux metatarsal function index and general health assessment using SF36, patients subjective rating of the result, dynamic foot pressure measurements using F-scan. Standing AP radiographs of both feet were also taken at the review. The results were compared within the two groups and the results statistically analysed. Results: The mean age of the patients in osteotomy group was 44 yrs and that in Kellers group was 44.5 yrs. The sex ratio was 16:4 (M:F) in both groups. The average follow up was 30 months in osteotomy group compared with 38 months in Kellerñs group. The mean Foot function index score was 3 ± 4 in osteotomy group. The hallux metatarsal score was 93 ± 13. In the Kellers group the scores were 24±33 and 80 ±22 respectively. The difference was statistically signiþcant. (Paired T test two tailed p< .05). The scar problems too were higher in Kellerñs group (9 compared to 4). Subjectively the osteotomy group rated the result more satisfactory. Conclusion: In patients with hallux valgus distal metatarsal osteotomy produces better results in comparison to Kellerñs arthroplasty in patients less than 55 yrs at a mean follow up of 33 months.