[Objective] To explore the clinical outcomes of joint replacement combined with plate fixation for intertrochanteric frac- tures in the elderly. [Methods] A retrospective study was done on 18 elderly patients who received hip replacement combined with olecra- non locking plate fixation for femoral intertrochanteric fractures. [Results] All the 18 patients were successfully operated on without serious complications, such as cardiovascular events, pulmonary embolism and death happened in anyone of them during the perioperative period. All patients were followed up for more than 12 months, and resumed full weight-bearing activity in (39.65±2.56) days. The Harris score in- creased from (81.27±2.82) at 6 months after operation to (87.87±3.25) at the latest follow-up, which was statistically significant (P＜0.05) . At the last follow-up, 17 patients returned to their pre-traumatic activity and daily life level, whereas 1 patient did not fully return to the pre-traumatic activity level. During the follow-up period, there were no complications such as prosthesis loosening, dislocation, fracture nonunion, plate screw loosening and refracture. [Conclusion] This hip replacement combined with olecranon locking plate fixation for femo- ral intertrochanteric fractures in the elderly does get satisfactory outcomes, with early postoperative ambulation and fewer complications.