Objective: To investigate the predictive effect of femoral calcaneal apex distance on the prognosis of femoral intertrochanteric fractures treated with Asian proximal femoral nail internal fixation. Methods: From January 2015 to January 2019, 160 patients with intertrochanteric fractures were treated with Asian proximal femoral nail fixation. The patients were followed up for 1 year and the prognosis was counted. The patients with good prognosis were set as good group, and those with poor prognosis were set as poor group. To compare the two groups of patients with intraoperative femoral calcaneal distance and general information. Logistic regression analysis was used to analyze the prognostic factors of Asian proximal femoral nail internal fixation for intertrochanteric fracture. ROC curve was drawn to analyze the predictive value of femoral talus apex distance on the prognosis of patients with intertrochanteric fracture after operation. Results: Compared with the good group, the proportion of osteoporosis in the poor group, the proportion of stage III ~ IV in Evans Jensen classification of fracture, and the proportion of preoperative complications with more than two kinds of complications were higher in the poor group, and the femoral distance to the apex was larger (P<0.05). Logistic regression analysis showed that Evans Jensen classification and femoral talus apex distance were important prognostic factors for patients with intertrochanteric fracture (P<0.05). ROC results showed that the best cutoff point for predicting poor prognosis of patients with intertrochanteric fractures was 32.34mm, and the AUC for predicting poor prognosis of patients with Asian proximal femoral nail was 0.759. Conclusion: The femoral calcaneal apex distance has certain value in predicting the prognosis of Asian proximal femoral nail internal fixation in the treatment of femoral intertrochanteric fracture, which can provide reference for clinical treatment of femoral intertrochanteric fracture.