Background/aim: The aim of this study is to compare the perioperative complications and overall survival of patients who underwent proximal femoral nail antirotation (PFNA) and patients who underwent cemented calcar-replacement hemiarthroplasty (CCRH) for unstable intertrochanteric fracture in patients aged 75 years and older. Materials and methods: A total of 94 patients who underwent PFNA or CCRH between 2010 and 2012 because of femur fracture (A2.2 and A2.3 according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification) were analyzed retrospectively. Hospitalization times, blood transfusion needs, reoperation rates, and overall survival were compared. Results: Forty-eight patients in the PFNA group and 46 patients in the CCRH group were included for analysis. There was no statisticasignificant difference between the two groups in terms of hospitalization times, blood transfusion needs, reoperation rates, and survirates. Conclusions: Both PFNA and CCRH techniques can be used for surgical treatment of unstable intertrochanteric femur fractures.