BACKGROUND: Hallux valgus is bilateral in up to 84 % of cases. In the setting of simultaneous bilateral correction, we aim to evaluate if minimally invasive percutaneous surgery (MIS) provides any advantage compared to conventional open surgery. METHODS: 52 feet (26 patients) undergoing simultaneous bilateral MIS surgery were matched by severity of deformity to 52 feet (26 patients) undergoing simultaneous conventional open surgery. Patients were followed for a minimum of six months. Pre- and post-operative radiographs and clinical records were reviewed. RESULTS: There were no significant differences in pre-operative function or pain between both groups. Post-operatively, the mean hallux valgus angle (HVA) was significantly lower in the MIS group. (HVA MIS - 8.6; Open - 11.8, P = 0.013). There were no significant differences in post-operative outcome and patient satisfaction between both groups. CONCLUSION: This study demonstrates that simultaneous bilateral MIS hallux valgus surgery can be considered for patients with bilateral symptomatic hallux valgus.