objective: to analyze the effect of internal fixation, reduction, epiphyseal closure, fracture type and other factors on the prognosis of adolescent patients with femoral neck fracture. Methods: A retrospective analysis was made on 43 adolescent femoral neck fracture patients who received surgical treatment in our hospital''s Department of Traumatic Orthopedics, including 29 males and 12 females. The average age was 15.13 years old (ranging from 12 to 17 years old), with 24 cases of closed reduction and 19 cases of open reduction. 32 cases were fixed with hollow nails and 11 cases with DHS. Results: 2 of the 43 patients had fracture nonunion and 5 femoral head necrosis. There was no statistical correlation between internal fixation, reduction, epiphyseal closure ,fracture type the incidence of complications. Conclusion: we tend to recommend open reduction and internal fixation with hollow nails for patients with incomplete epiphyseal closure, and kirschner wire is added to the interior of the hollow nails for fixation through the epiphyseal plate when necessary. For patients with Pauwels angle > 70°, we may need to be alert to the possibility of nonunion of femoral neck fractures.