Background: trochanteric fractures are extracapsular fractures of the proximal femur between the greater and lesser trochanters. Approximately half of all hip fractures will be trochanteric fractures. Trochanteric fractures occur in a more aged population than do femoral neck fractures. These elderly people are more affected by osteoporosis and medical comorbidities. Objective: the aim of this study was to evaluate the results of primary hemiarthroplasty in management of intertrochanteric fractures in elderly patients. Patients and Methods: this study was a prospective study involving 20 patients with unstable trochanteric fractures performed at Orthopedic Department, Al Hussein and Sayed Galal, Al-Azhar University Hospitals between the period of September 2017 till March 2019. Patients were checked with X-rays, clinical evaluation, and functional assessment according to the Harris hip score (HHS). Results: in the current study, data on the effect of internal fixation versus endoprosthesis on mortality rate are available only for femoral neck fractures. When adjusted for age, there is no significant difference in the mortality rates for patients treated with internal fixation or hemiarthroplasty. Conclusion: It could be concluded that the use of hemiarthroplasty is recommended for cases with old age, osteoporotic bone, medical comorbidities, preexisting ipsilateral symptomatic degenerative hip disease or patients with renal failure or pathological fracture with metastases.