Objective To evaluate the clinical effects and indications of dynamic hip screw (DHS) and hemiarthroplasty in the treatment of intertrochanteric femoral fracture in the elderly patients. Methods We retrospectively reviewed the clinical data of 103 elderly patients diagnosed as intertrochanteric femoral fractures between January 2007 and December 2009 in our hospital. The DHS system was used in 71 patients, and hemiarthroplasty was used to treat the other 32 patients. The clinical data including operation time, blood loss volume, post-operative complications, fracture healing and function recovery were recorded and analyzed. Results In the DHS group, the mean operation time was (96.7±8.6)min; the mean blood loss volume was (317.7±26.5)ml. Harris￠s hip function was excellent in 32 cases, good in 26 cases, moderate in 6 cases, and poor in 7 cases, with satisfaction rate of 81.7%. In the hemiarthroplasty group, the mean operation time was (107.0±12.8)min; the mean blood loss volume was (335.3±28.1)ml. Harris￠s hip function was excellent in 10 cases, good in 14 cases, moderate in 2 case, and poor in 1 case, with satisfaction rate of 88.9%. Conclusions Both DHS and hemiarthroplasty are effective in the management for the intertrochanteric femoral fracture in the elderly patients, if combined with anti-osteoporosis treatment and suitable indications. The short and middle-term outcome are both satisfactory.