[Objective] To introduce the surgical technique and preliminary clinical outcome of total hip arthroplasty with long-stem cementless femoral component for end-stage hip arthropathy complicated with old subtrochanteric fracture. [Methods] In 2021, a patient with end-stage femoral head necrosis combined with old subtrochanteric fracture was admitted to our department and received total hip ar- throplasty (THA) with long-stem cementless femoral component. The femoral head was removed through the posterolateral approach under general anesthesia, and the acetabular component was placed firstly, and then the subtrochanteric fracture ends was exposed by lengthening the incision distally. After reduction, the fracture end was temporarily fixed with steel plate and cerclage wires. Finally, the long-stem ce- mentless femoral component was inserted in place to fix the fracture, subsequently, the head component was inserted, the hip was reduced and the incision was sutured in layers. [Results] The patient underwent the operation successfully with the hip prostheses in good position on radiographs. One week after operation, the patient was able to walk himself with an assistant device. The Harris score of the left hip was marked as 77, which was satisfactory curative effect. [Conclusion] This total hip arthroplasty with long-stem cementless femoral compo- nent proves effective treatment for end-stage hip arthropathy complicated with old subtrochanteric fracture.