Objectives: To compare the recent clinical efficacy of FNS and ICCS on the treatment of femoral neck fractures.Methods: 73 cases with femoral neck fractures who received treatment of FNS or ICCS internal fixation from January, 2018 to March, 2021 were analyzed retrospectively. The patients were divided into two groups according to different ways of internal fixation, 33 of whom received FNS internal fixation treatment (FNS Group): 16 males and 17 females, whose ages range from 29 to 73, with average age of 53.03; 40 of whom received ICCS internal fixation treatment (ICCS Group):16 males and 24 females, whose ages range from 21 to 74, with average age of 52.03. The indices were observed and compared, such as the surgical time, operative blood loss, fluoroscopy times, the length of operative incision, time in hospital, time of frature healing, time of partial and full weight-bearing, the degree of femoral neck shortening between the two groups, etc. Results: There were statistically significant differences in the aspects of operative fluoroscopy times, time of fracture healing, time of partial and full weight-bearing and Harris hip score, etc. (p＜0.05). The fluoroscopy times, time of fracture healing and time of postoperative partial and full weight-bearing in FNS Group were significantly lower than that in ICCS Group. The femoral neck shortening degree in ICCS group was significantly severer than that in FNS Group, and Harris hip score in FNS was significantly better than that in ICCS Group in the final follow-up. There was no statistically significant difference in the comparison of postoperative complications between two groups, like internal fixation failure, bone nonunion, avascular necrosis of femoral head and so on.( P＞0．05 ).Conclusions: FNS can reduce the degree of femoral neck shortening and operative fluoroscopy exposure and has the advantages of accelerating fracture healing and facilitating better recovery of hip function. So FNS can replace ICCS to treat femoral neck fractures.