Objective:To investigate the results of hip arthroplasty for the treatment of severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture. Methods:From June 2007 to September 2013,8 patients (8 hips) with se-vere comminuted proximal femoral fracture combined with ipsilateral acetabulum fracture were treated with hip arthroplasty. All patients were male and using biological prosthesis. Aged from 33 to 64 years old with an average of 41.9 years. According to Harris score in aspect of pain,function,range of motion to evaluate clinical effects. Results:There was no untoward reaction in 8 pa-tients. And bed rest at 3 months after operation ,waiting for acetabulum fracture healed to out of bed activity. There was no com-plications such as pneumonia ,bedsore and so on in the patients. Follow up time was from 9 to 72 months with an average of 35.8 months,the wound healed,there was no the subsidence and loosening of prosthesis,no dislocation and infection. The mean of Harris score was 87.5 points after operation. Conclusion:The effect of the hip replacement in treating severe comminuted proxi-mal femoral fracture with ipsilateral acetabulum fracture is confirmed. It can restore motor function and reduce traumatic compli-cation,may serve as a substitute for internal fixation of difficult operation. The long term efficacy is necessary to further observe.