Surgical arthrodesis of the hallux interphalangeal joint can be used as an isolated procedure to address painful or deformed joints or in conjunction with other procedures to create a better functioning first ray. This type of arthrodesis may be necessary in neuropathic patients to prevent ulcerations or amputations. Several etiologies exist that result in a deformity about the hallux IPJ, some can be pain-free, others may be extremely debilitating to a patient. Many different surgical approaches have been described and used when performing a hallux IPJ arthrodesis. Developing your own technique enables you to understand what works for you and your patients and allows you to determine the most effective way to achieve arthrodesis. The goal is to prevent painful nonunions and address the underlying deformity. It is also important to understand that a successful arthrodesis in a patient who has a neurological disorder is the only way to prevent recurring deformities secondary to the underlying disease process. The ability to properly work-up and surgically address deformities of the hallux interphalangeal joint is necessary for those who perform lower extremity surgery.