Objective To describe the survival of elderly patients with intertrochanteric fracture of femur after femoral head replacement, and to explore the risk factors of death. Methods This study retrospectively collected in January 2015 - October 2019 in a hospital orthopedic line of the femoral head replacement conforms, 131 cases of elderly patients were included, collecting information included in the study of general data and clinical diagnosis and treatment, through the follow-up of the patients' survival outcome. Cox proportional risk regression model was used to screen risk factors. Results The 1-year survival rate was 0.939 and the 2-year survival rate was 0.832. Cox regression showed that increasing age and 2 comorbidities were risk factors, while normal BMI was protective factor. Conclusion Elderly patients with intertrochanteric fracture of femur have a higher risk of death after femoral head replacement, especially for the elderly patients with a large number of complications, attention should be paid to strengthen perioperative risk optimization management.