A periprosthetic supracondylar femoral fracture is one of the complications of the total knee arthroplasty(TKA). The periprosthetic supracondylar femoral fracture after TKA occurs approximately 0.3% to 2.5% and various methods have been introduced to treat this fracture. We report three cases of supracondylar femoral fractures following TKA, with brief review of pertinent literatures, in which retrograde supracondylar intramedullary nail provided satisfactory results. In severe osteoporotic patient, firm fixation of the nail was obtained by using cement and early motion of the knee joint was possible. In addition, we found that the supracondylar intramedullary nail could be used without insertion difficulty in all PCL retaining TKA systems which were available in use in our country.