Twenty-four patients (33 feet) underwent metatarsophalangeal joint arthrodesis using a vitallium plate with an additional oblique screw. The mean age was 55 years (range, 37–68) with a mean follow up of 28 months (range, 16–45). Patients were evaluated using the American Foot and Ankle Society clinical and radiographic guidelines. Twenty-three patients (32 feet) went on to complete fusion within 12 weeks, one patient had a non-union, the fusion was repeated successfully. One patient had deep infection and two patients had persistent foot pain. Hallux valgus angle was reduced by a mean of 12 degrees and intermetatarsal angle by a mean of 2 degrees. Patient satisfaction was high with relief of symptoms and improved appearance of the foot. First metatarsophalangeal joint arthrodesis using a vitallium plate with an oblique interfragmentary screw is a successful procedure with a high fusion rate, low complication rate and a high level of patient satisfaction