[Objective]To compare the clinical efficacy of Ganz surgery approach with K-L surgery approach in the treatment of Pipkin type I and II femoral head fractures.[Methods]A retrospective study was conducted on 24 patients with femoral head fractures treated in our hospital from April 2017 to February 2022, according to the different surgical approach, they were divided into Ganz group and K-L group. Recovery of hip function was evaluated by VAS score and Harris score, heterotopic ossification was assessed by Brooker scale, osteonecrosis of the femoral head by Ficat staging and osteoarthritis by Tonnis classification.[Results]There was no clear difference between the two groups in postoperative follow-up VAS scores (p>0.05). The Harris score in the Ganz group was better than that in the K-L group (p<0.05) at 1 month postoperatively, and there was no significant difference between the two groups at the last follow-up (p>0.05). The VAS score and Harris score of both groups at last follow-up were significantly improved compared with 1 month after surgery (p<0.05). There were no statistically significant differences between groups for heterotopic ossification, osteonecrosis of the femoral head, and osteoarthritis (p>0.05).[Conclusion]The Ganz approach has the advantages of short operation time, less intraoperative bleeding, fast recovery of hip function after surgery, which is a safe and effective surgical method.