Objective To explored the clinical effect of bone cement type and biological type artificial hemi hip replacement in the treatment of elderly patients with femoral neck fracture. Methods A total of 90 elderly patients with femoral neck fracture admitted to the Department of Orthopedics in Yangdong District People′s Hospital of Yangjiang City from January 2020 to June 2021 were selected as the study subjects,and they were divided into control group(45 cases) and observation group (45 cases) by random number table method. The control group used biological artificial hemi hip replacement, and the observation group used bone cement artificial hemi hip replacement. Clinical indicators, Harris hip function score, visual analogue scale (VAS) score and postoperative complications were compared between the two groups. Results The operation time of observation group was shorter than that of control group, the intraoperative blood loss and postoperative drainage volume were less than those of control group, the hospital stay was shorter than that of control group, and the weight-bearing time was earlier than that of control group, with statistically significant differences (P＜0.05). The Harris score of the observation group was higher than that of the control group at one month after surgery, and the rate of excellent and good operation effect was higher than that of the control group, with statistically significant differences (P＜0.05). Before surgery, there was no significant difference in VAS score between the two groups (P＞0.05). One month after surgery, VAS score of observation group was lower than that in the control group, the difference was statistically significant (P＜0.05). There was no significant difference in the total incidence of complications between the two groups (P＞0.05). Conclusion Compared with biological type artificial hemi hip replacement, bone cement type artificial hemi hip replacement is more significant in the treatment of senile femoral neck fracture, with advantages such as short operation time, less intraoperative blood loss and postoperative drainage, short hospital stay,and early weight-bearing time, which can effectively improve the short-term effect and reduce postoperative pain.