130 patients with hallux valgus with or without associated first ray insufficiency scheduled for a modified Lapidus procedure were included in this trial to evaluate the effects of early postoperative weight-bearing on outcomes over the first 12 months following surgery. Patients included in the trial were randomized to an early weight-bearing group or to a control group which received the standard of care. Patients in the early weight-bearing group started progressive weight-bearing 2 weeks while the standard of care group was kept non-weight-bearing until 6 weeks. Patients were followed up at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months. Outcomes assessed were first tarsometatarsal joint fusion, the Short Form 36-Item General Health Survey (SF-36), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the Short Musculoskeletal Functional Assessment (SMFA), a visual analog scale, and the Foot Function Index (FFI). The results indicated that early weight-bearing was associated with increased self-reported function after 6 weeks when compared to standard of care (weight-bearing at 6 weeks), without an apparent significant increase in postoperative complications.