Background: Intertrochanteric (IT) fractures are common in elderly & frequently compounded by osteoporosis & comminution at fracture site. Hence hemiarthroplasty may offer prognostic advantages over internal fixation in management. Objective: to analyze the role of primary hemi–arthroplasty in cases of unstable osteoporotic IT femur fractures in elderly and its comparison with proximal femur nail. Methodology: 35 elderly cases of unstable IT fracture were enrolled. 17 patients were managed with hemi–arthroplasty and 18 were managed with PFN. 4 participants were lost to follow up. Remaining 31 patients were followed up for average of 8 months and evaluated for intraoperative/postoperative parameters. Observations:  Mean HHS at 6 weeks for prosthesis and fixation group were 84.3 and 74.8; and at 6 months were 84.5 and 74.8 respectively. Conclusion: cemented modular hemiarthroplasty is a viable option to treat IT fractures & may be considered in elderly patients of osteoporotic unstable inter trochanteric fractures.