Background: Trochanteric femoral fractures constitute 3% of all fractures and a large portion of fractures after the age of 60. Trochanteric femoral fractures in elderly usually occur due to a low-energy trauma and can be treated successfully with internal fixation or prosthesis depending on the patient's age and general condition and also the quality of the bone. Aim and Objective: This is a systematic review to evaluate different techniques of fixation used in management of intertrochanteric fracture, regarding the efficacy results and complication of each technique in the literature. Methods: A review was performed using the Cochrane Central Register of Controlled Trials, PubMed, and MEDLINE as database for search. Results: the results of the study revealed that  the percent of changes were 44.69% of RT side group A, 45.26% of RT side group B, 40.86% of LT side group A, and 45.90% of LT side group B with no significant difference between the studied groups. included studies focusing on intertrochanteric fracture fixation in elderly patients as the main research point, if it was not the main point, paper was excluded. Conclusion: Prosthetic replacements can treat unstable intertrochanteric fracture well, if operative indication is correctly selected. It is suitable for elderly patients and the operation should be performed by experienced surgeons.