Abstract Objective To investigate the clinical effect of Vancouver type B1 and B2 periprosthetic femoral fracturestreated with PHILOS. Methods From September 2017 to January 2019, PHILOS was applied to treat 7 cases of Vancouver type B1 and B2 periprosthetic femoral fractures, including 5 type B1, 2 type B2 fractures. 5 males and 2 females, aged 57 to 86 years, with an average age of 71.7 years. Harris score was used to evaluate the postoperative functional recovery of the patients, and X-ray images were taken to evaluate the fracture healing, as well as the position of PHILOS and femoral prosthesis. Results All 7 patients were followed up for 12 to 24 months, with an average follow-up of 17 months. At the last follow-up, the Harris score was 83 ~ 89 points, with an average of 86 points. The X-ray showed that all the fractures were healed, without loosening of the femoral prosthesis and failure of the PHILOS. All patients were able to walk with full weight bearing, and the pain and lameness were significantly improved. Conclusion The unique application of PHILOS in the treatment of Vancouver type B1 and B2 periprosthetic femoral fractures is a good choice with simpler surgery, lower medical expenses and satisfactory clinical results.