Objective To investigate the application and efficacy of SuperPATH approach for hip arthroplasty in the elderly patients with femoral neck fracture. Methods A total of 39 elderly patients with unilateral femoral neck fracture admitted to the Orthopedic Department of Aidebao Hospital from September 2015 to March 2017 were enrolled in this study. They were divided into SuperPATH approach group (n＝14) and posterolateral approach group (n＝25) according to the approach they received. The operation time, intraoperative bleeding volume, postoperative drainage volume, and visual analogue scale (VAS) score within 24 h after operation were compared between the 2 groups. After 3 months′ follow-up, the independent walking time, complications and Harris hip joint score were compared between them. SPSS statistics 17.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison based on different data types. Results Compared with the posterolateral approach group, the patients with SuperPATH approach had less amounts of intraoperative blood loss [(101.4±16.7) vs (135.3±21.6)ml] and post-operative drainage [(70.4±10.2) vs (85.9±16.4)ml], shorter incision length [(6.8±0.7) vs (10.1±0.9)cm] and lower VAS score [(3.5±1.0) vs (6.8±1.7)scores, P<0.05]. At the end of the last follow-up, no dislocation, infection or loosening occurred in both groups. The independent walking time was significantly shorter in the SuperPATH group than in the posterolateral approach group in 3 months after operation [(2.8±1.2) vs (9.2±2.2)d, P<0.05]. Conclusion SuperPATH approach is a minimally invasive approach for hip replacement with the advantage of rapid recovery, especially suitable for the elderly patients.