Can I do a sargable first letter match on two tables? select value 
from persons p join persons2 p2 
    on left(p.lastname,1) = left(p2.lastname,1)


SQL Server. Is there any way to make this SARGable/run faster? I can't create columns on persons table, but I can create columns on persons2.
If the lastname column is indexed in at least one of the tables then you could also use LIKE

SELECT *
FROM   persons p
       INNER JOIN persons2 p2
               ON p2.lastname LIKE LEFT(p.lastname, 1) + '%' 




The plan for this can have a seek on the table specified to the left of the like. 

i.e. ON p.lastname LIKE LEFT(p2.lastname, 1) + '%' would not be able to make use of the index on persons2that was used above but could seek one on persons.

The suggestion in the other answer of indexing a calculated column on both sides is more flexible however. As for a nested loops plan either table can be on the inside and it would also allow a many to many merge join without requiring a sort.