Background: Unstable osteoporotic intertrochanteric fractures are complex fractures and treatment for this fractures in elderly patients is challenging because of poor bone quality. The present study was undertaken to evaluate the functional outcome of primary hemiarthroplasty in unstable osteoporotic inter–trochanteric fractures in elderly patients. Method: In 35 patients aged >60 years with diagnosis of unstable osteoporotic intertrochanteric fractures (AO/OTA type 31–A2.2 and 31–A2.3 and Evans type III or IV fractures) primary hemiarthroplasty was done and patients were followed up at 1 month, three month, six month and one year postoperatively. Results: Among 35 patients, 24 (68.57%) were females and 11 (31.42%) were males with a mean age of 75.21 years. 2 patients died due to unrelated cause (myocardial infarction) within 6 months of surgery and remaining 33 patients were followed up to an average of 11.7 months. The mean surgery time was 73 min with an average intraoperative blood loss of 340 ml. 4 patients needed blood transfusion postoperatively. The patients walked on an average 3.6 days after surgery. One patient had superficial skin infection and one had bed sore. A total of 31 out of 33 patients (93.93%) had excellent to fair functional results and 1 had poor result with respect to the mean Harris hip score of 85.4±7.63, ranged from 56–95. One patient who had neurological comorbidity refused to walk postoperatively and was labeled as failed result. Conclusion: In the elderly, unstable osteoporotic intertrochanteric fractures could be effectively managed by primary hemiarthroplasty, which provides early mobilization with a stable, pain–free, and mobile joint with acceptable complication rate.