[Objective] Investigate the postoperative efficacy that cemented long-stem and ordinary -stem prosthesis artificial femoral head replacement for treatment of elderly unstable intertrochanteric fractures. [Methods] A retrospective analysis was performed on postoperative investigation data of 120 elderly patients with unstable femoral intertrochanteric fractures that treated with cemented long-stem and ordinary-stem prosthesis hemiarthroplasty in our hospital from January 2016 to January 2020. Perioperative and postoperative data date were compared between the two groups, such as incision healing grade, fracture healing time, fracture reduction grade, femur length difference, prosthesis stability at the last follow-up, and postoperative Harris score, range of motion, et al. [Results] A total of 107 patients were complete tracking including 55 long-stem and 52 ordinary-stem prosthesis patients. The perioperative data between the two groups were significantly different only in the early postoperative weight-bearing time, postoperative hospital stay, and total hospital stay (P<0.05); and there were no significant differences in the remaining indicators. The hip function score and range of motion of the two groups gradually recovered with time, and in the data within the group showed significant differences at different time stage (P<0.001), but there was no significant difference between the two groups at corresponding time stage (P>0.05). Moreover, there was no significant difference in radiological data between the two groups. [Conclusion] Both cemented long-stem and ordinary-stem for artificial femoral head replacement can be used for the treatment of elderly patients with unstable intertrochanteric fractures. There seems to be no significant difference in short-term postoperative efficacy, but long-term efficacy needs to be further tracked.