[Objective] To investigate the mid-term clinical effect of pedicled iliac bone flap cannulated screw fixation of displaced femoral neck fracture in young adult. [Method] Retrospective analysis of the clinical data of 19 young and middle-aged patients with displaced femoral neck fractures treated with pedicle iliac bone flap hollow nail fixation from January 2014 to September 2020. Evaluate clinical and imaging results. [Results] 19 patients were followed up for (60 ± 7.8) months after surgery, with a complete weight-bearing time of (12 ± 4.3) weeks. One case of internal fixation failure, and the remaining 18 patients underwent postoperative X-ray and CT examinations, with an average clinical healing time of (4.5 ± 6.7) months evaluated; At the last follow-up, the Harris score of the hip joint was (90.57 ± 4.64), with 15 cases being excellent, 1 case being good, 2 cases being fair, and 1 case being poor. There were 2 cases of femoral head necrosis. [Conclusion] The displaced femoral neck fracture in Young adult was fixed with pedicled iliac bone flap cannulated nails, and the medium-term clinical effect was satisfactory.