Objective To compare the operation and clinical effects of total hip arthroplasty and hemiarthroplasty in the treatment of fracture of femoral neck in elderly patients.Methods 58 elderly patients( ≥85 ) with femoral neck fracture were divided into observation group(n=39) and control group(n=19).The observation group was treated by hemiarthroplasty and the control group was treated by total hip arthroplasty.The operation time,blood loss,hospital stay,postoperative hip functional score and complications were observed and compared between the two groups.Results The operation time and blood loss of the observation group were(71.6 ±9.3)min and (266.8±113.5) ml respectively,which were significantly less than those of the control group ( t=7.89,3.43,all P ＜ 0.05 ).Therer was no significant difference of the hospital stay,postoperative hip functional score and incidence rate of complications between the two groups.Conclusion Hemiarthroplasty was an ideal rmethod in treating fracture of femoral neck in elderly patients,which was effective and simple.