Femoral neck fractures in the elderly populations represent a significant health care problem. A prospective study was carried out in Coimbatore medical college in the department of orthopaedics, between the period of July 2010 to August 2015 in healthy adult patients who underwent total hip replacement for the displaced fracture neck of the femur under State health insurance scheme in low socioeconomic and education patients. We have done primary uncemented total Hip replacements in 74 patients who sustained displaced fracture neck of femur, Gardens type 3 and type 4 fractures. The functional outcome was excellent to good in almost 90% of our cases. Primary total hip replacement is a good option for displaced fracture neck of femur in elderly patients otherwise physically active before injury. The functional outcome and complication rates are comparable or better to other methods of treatment in this age group.