[Objective] To introduce the surgical techniques and clinical outcomes of total hip arthroplasty with long-stem cementless prosthesis for end-stage hip joint disease with old subtrochanteric femoral fractures. [Methods] After general anesthesia, a posterolateral approach was taken, the femoral head was removed by secondary osteotomy method, first the acetabular side replacement was performed, then the subtrochanteric femoral fracture ends was exposed, and the fracture ends were temporarily fixed with plate and wires after reduction, next the plate and distal wires were removed after the long-stem cementless prosthesis was implanted, and finally fixed the fracture with proximal wires. [Results] For end-stage hip joint disease with old subtrochanteric femoral fracture, total hip arthroplasty with long-stem cementless prosthesis solves the problem of fracture and hip joint disease at one stage, and achieves satisfactory clinical outcomes. [Conclusions] Total hip arthroplasty with long-stem cementless prosthesis is an effective treatment for end-stage hip joint disease with old subtrochanteric femoral fractures.