PURPOSE: The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in treatment of unstable femoral intertrochanteric fracture in elderly patients. MATERIALS AND METHODS: We reviewed 93 patients and followed up more than one year. Group I(n=34, Singh index <3 with more than 70 year old) were treated by bipolar hemiarthroplasty. Group II(n=20) with same condition were treated by compression hip screw. Group III(n=39, Singh index >4 with more than 70 year old) were treated by compression hip screw. RESULTS: Group I and III patients showed satisfactory result over than good by merle D 'Aubigne hip rating scale. Among Group II(n=20), 16 cases showed under 'poor 'according to functional scale. Complication was 1 cases in group I, 19 cases in group II and 8 cases in group III. CONCLUSION: We suggest bipolar hemiarthroplasty as first choice of treatment for osteoporotic elderly patients with unstable intertrochanteric fracture, especially who have combined medical problems or poor general condition.