Objective To compare the clinical effects of hip replacement and internal lixation treatment for aged patients with fracture of femoral neck.Methods One hundred and twelve cases patients with fracture of femoral neck were choosed and divided into the control group (n =56) and observation group (n =56) according to the will of patients and family.The control group was treated by incision fixation while the observation group was given hip replacement therapy.All patients were followed up for 6 months after the operation time.Intraoperative blood loss,hospital stay,bed time,postoperative complications and Harris joint scores of the two groups were compared.Results The operation time and intraoperative blood loss of the observation group were significantly higher than those of the control group((98.6±23.8) min vs.(54.2± 16.4) min,(324.6 ±43.8) ml vs.(158.6±26.8) ml;t=4.468,5.624;P＜0.05);The bed time was much shorter than that of the control group((16.6±2.8) d vs.(68.6±5.8) d;t=8.248,P＜0.05).The case of pressure sores,lung infection and mode again of the observation group were significantly less than those of the control group(P＜0.05),while the Harris joint scores were significantly higher than the control group (89.7％ vs 58.9％,x2 =14.423,P ＜0.05).Conclusion Hip replacement can improve the joint function and enhance the quality of life for patients of fracture of femoral neck.