Objective To summary the clinical efficacy of artificial femoral head replacement to advanced age patients with osreoporosis and unstable intertrochanteric femur fractures and discuss the superiority of joint replacement. Methods 27 patients with with osreoporosis and unstable intertrochanteric femur fractures were accepted artificial femoral head replacement early. Bleeding amount, operation time and hospital stay time etc were observed. Results All of the 27 patients smoothly passed the surgery and no cases died in hospital period. After 3 to 9 days(average 5.5 days) , patients could walk on ground with weight bearing and the time in hospital was 16 to 27 days,average 21days. The 27 patients all got followed-up for 6 to 36 months, average 21 months. One patient died of the lung infection in three months later and other patients all get life self-care ability back in 3 to 6 months after operation. Conclusion Artificial femoral head replacement to advanced age patients with osreoporosis and unstable intertrochanteric femur fractures is safe with little complication and low death rate and patients can do exercise out of bed early. It is an effective treatment method, but its long-time effect must continue to observe.