Objective To evaluate the value of Orthopaedic POSSUM scoring system in predicting mortality and morbidity for the patients underwent femoral shaft fractures.Methods The mortality and incidence of postoperative complications was predicted with in a retrospective study of 155 cases of femoral shaft fractures.Results The estimated incidence of postoperative complications is 45/155, which has no statistical significance with the real incidence 39/155 (?2=0.59,P=0.44), The estimated morbidity by POSSUM is more accurate in high-risk subgroup than in low-risk one. The estimated mortality is 10/155, which also has no statistical significance with the real mortality 8/155 (?2=0.24,P=0.63).Conclusion The POSSUM scoring system can predict postoperative mortality and morbidity for the patients underwent femoral shaft fractures efficiently.