Hallux valgus deformity (HV; bunions) is a common forefoot deformity, that can cause pain and inflammation, secondary osteoarthritis in the 1st MTPJ, and deviation of the remaining digits resulting in hammer and claw toes. Corrective surgery for HV has evolved from conventional open procedures to multiple generations of minimally invasive surgery (MIS). Purpose: Analyse radiographic and patient-reported outcomes pre- and post-4th generation percutaneous bunionectomy by Joint Vision Orthopaedic Research Group. Methodology: A prospective single-surgeon series of consecutive patients undergoing 4th generation MIS for HV with minimum 6-week follow-up. Patient outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ) and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hallux Metatarsalgia Score. Radiographic outcomes were assessed using HV angle, intermetatarsal angle, and distal metatarsal articular angle. Demographics, duration of symptoms, procedure duration, and complications were also assessed. Results: Patient reported outcomes significantly improve post 4th generation MIS. Radiological alignment of the proximal phalanx and 1st metatarsal head also improved. Post-operative complication rates were low and length of surgery reduced over time. Conclusion: Forth generation MIS for HV deformity can significantly improve HV symptoms with a low risk of complications.