[Objective] To compare the short-term clinical outcomes of proximal femur bionic nail (PFBN) versus proximal femoral nail anti-rotation (PFNA) for intertrochanteric fractures in the elderly. [Methods] From October 2020 to June 2021, a total of 40 elderly pa- tients with intertrochanteric fracture of femur were enrolled into this study, and randomly divided into two groups. Of them, 20 patients had fractures fixed with PFBN, while the remaining 20 patients were with PFNA. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had operation performed successfully without serious complica- tions. There were no significant differences in intraoperative blood loss, incision healing grade and hospital stay between the two groups (P＞ 0.05) . The PFBN group resumed walking significantly earlier than that in PFNA group (P＜0.05) , but the former was significantly greater in terms of operation time and intraoperative fluoroscopy times than the latter (P＜0.05) . All the patients in both groups were followed up for 6~ 9 months, with an average of (7.3±1.1) months. The PFBN group resumed full weight-bearing activity significantly earlier than the PFNA group (P＜0.05) . The VAS score significantly decreased (P＜0.05) , while the Harris score, hip flexion-extension range of motion (ROM) and internal-external rotation ROM significantly increased in both groups over time (P＜0.05) . At 1 month after operation, PFBN group was sig- nificantly better than the PFNA group in term of Harris score (P＜0.05) . Radiographically, there were no significant differences in fracture reduction quality and fracture healing time between the two groups (P＞0.05) . At last follow-up, the PFBN group maintained significantly greater femoral neck-shaft angle than PFNA group (P＜0.05) . [Conclusion] This proximal femur bionic nail for proximal femoral intertro- chanteric fracture in elderly is more stable, allowing walking early postoperatively, which is beneficial to fracture healing and prevent coxa vara.