[Objective] To compare the clinical efficacy of proximal femoral nail anti-rotation (PFNA) versus InterTAN intramedullary nail combined with anti-osteoporosis therapy for osteoporotic intertrochanteric fractures of the femur. [Methods] A total of 102 elderly pa- tients who underwent surgical treatment for osteoporotic intertrochanteric fracture of the femur in our hospital from January 2016 to January 2019 were included in this study. According to the results of preoperative doctor-patient communication, 53 patients received PFNA fixa- tion, while the other 49 patients received InterTAN fixation. The Perioperative, follow-up and imaging documents were compared between the two groups. [Results] All patients in both groups had surgical procedures performed successfully. The InterTAN group proved signifi- cantly superior to the PFNA group in terms of operation time, incision length and intraoperative blood loss (P＜0.05) . All patients were fol- lowed up for 12~32 months, with an average of (22.52±6.41) months. InterTAN group resumed walking and full weight bearing activity sig- nificantly earlier than PFNA group (P＜0.05) . The hip extension-flexion range of motion (ROM) , internal-external rotation ROM, and Har- ris score significantly increased postoperatively compared with those preoperatively in both groups (P＜0.05) , which in the InterTAN group were significantly better than those in the PFNA group at 6 months and the latest follow-up (P＜0.05) . With respect to imaging evaluation, the Inter TAN group got significantly higher rate of proper fracture reduction than the PFNA group (P＜0.05) . By the time of the latest fol- low-up, the fracture healing was achieved in all patients of both groups without nonunion. At the latest follow-up, the InterTAN group was significantly superior to the PFNA group in terms of femoral shortening and femoral neck-shaft angle (P＜0.05) . [Conclusion] For osteopo- rotic intertrochanteric fractures of the femur, the InterTAN used as internal fixation is considerably better than the PFNA.