【Abstract】 Objective To observe and analyze the clinical results of the treatment of femoral neck fracture with a new minimally invasive approach through the superior articular capsule. Methods From May 2019 to July 2021, 21 cases of femoral neck fractures were treated with open reduction operation through the superior articular capsule minimally invasive approach, autologous iliac bone graft, and hollow screw internal fixation. Among them, there were 8 cases of GardenII, 9 cases of GardenIII and 4 cases of Garden IV,.The operation time, intraoperative bleeding and postoperative hip function recovery were recorded and analyzed. The shortening of femoral neck before and after weight bearing was compared. Results All patients completed surgical treatment. The operation time was 70 ~ 140 min, with an average of (101.90 ± 18.34) min. Intraoperative bleeding was 50 ~ 260 ml, with an average of (125.24 ± 52.40) ml. 21 patients were followed up for 12 ~ 26 months. No fracture nonunion occurred. One case had necrosis of femoral head. The average horizontal shortening and vertical shortening of the femoral neck were (3.95 ± 0.88) mm and (5.49 ± 0.54) mm respectively before the full weight-bearing of the affected limb after operation. The average horizontal shortening and vertical shortening of the femoral neck were (4.05 ± 0.87) mm and (5.58 ± 0.57) mm respectively one year after operation. There was no significant difference between the two sets of data（t=-0.527，P=0.601；t=-0.371，P=0.713）. One year after operation, the Harris score of hip joint was 84.95 ± 9.36, of which 10 cases were excellent, 8 cases were good, 2 cases were fair and 1 case was poor. Conclusions Open reduction through the upper joint capsule minimally invasive approach and hollow compression screw internal fixation for the treatment of femoral neck fracture can reduce the occurrence of femoral neck shortening, with low complication rate, high fracture healing rate and satisfactory treatment effect.