Objective To explore and analyze the timing and postoperative effect of proximal femoral nail anti-rotation( PFNA) for the treatment of elderly femoral intertrochanteric fracture. Methods From September 2011 to March 2013, there were 36 elderly patients with femoral intertrochanteric fractures in our hospital, including 6 cases of type A1, 16 cases of type A2, and 14 cases of type A3. All the 36 pa-tients received PFNA and systematic rehabilitation exercise. Treat the underlying disease and strengthen the nursing to prevent thrombosis at the same time. Hip joint function was evaluated by the Harris score system. Results The average hospitalization of patients is 4 weeks. The wound healing was good in 30 cases and wound infection occured in 2 cases who recovered after subsequent treatment, and the other 4 pa-tients died due to complicated internal medicine diseases. 21 cases of patients were followed up,and their hip joint function recovered well according to the Harris score system, including 12 cases of excellent, 6 cases of good, and 3 cases of eligible, with an excellent and good rate of 85%. Conclusion The application of PFNA for the treatment of elderly femoral intertrochanteric fractures has the advantages of less damage to the local blood supply and better recovery of fracture healing and hip joint function, which is an ideal treatment for the elderly pa-tients with femoral intertrochanteric fractures.