Objective To investigate the application of different intramedullary nail systems in senile femoral intertrochanteric fracture.Methods A tatal of 80 patients with femoral intertrochanteric fracture who admitted in the hospital from February 2017 to February 2019 were divided into the proximal anti-rotation intramedullary nail (PFNA)group and the proximal femoral intramedullary nail (PFN) group according to the random number table method, with 40 cases in each group.PFEA group accepted proximal femoral nail anti-rotation (PFNA) surgery, and PFE group accepted proximal femoral nail (PFN) surgery.The surgical indexes, hip joint function, quality of life and complications were compared between two groups.Results The operation time of PFEA group was shorter than that of PFE group, and the intraoperative bleeding volume in PFEA group was less than that in PFE group (P<0.05).The excellent rate of hip joint recovery in PFEA group was higher than that in PFE group (P<0.05).After surgery, the scores of Short Form 36-item Health Survey (SF-36) scale in PFEA group were higher than those in PFE group (P<0.05).The total incidence of postoperative complications in PFEA group was lower than that in PFE group (P<0.05).Conclusion PFNA surgery is effective in treating femoral intertrochanteric fractures, with less trauma and fewer complications, which is conducive to early postoperative rehabilitation.