[Abstract] In order to investigate the clinical efficacy of InterTan intramedullary nail and Zimmer natural nail system (ZNN) in the treatment of intertrochanteric fractures in the elderly. Patients with femoral intertrochanteric fractures older than 65 years who were treated from January 2013 to January 2018 were enrolled. A total of 114 patients were eventually included. There were 56 males and 58 females. The average age was77.88 ± 6.92 years (range 67 to 91 years). 69 patients underwent InterTan intramedullary nailing and 45 patients underwent ZNN intramedullary nail. The duration of operation, the amount of intraoperative blood loss, the visual analogue scale (VAS) of third day, seventh day after surgery, and the first and third months after surgery were compared between the two groups. Postoperative complications and hip Harris scores in the first and third months after surgery were also recorded. The results show that there is a statistically significant difference in the duration of surgery between the two groups (p<0.01). The InterTan intramedullary nail fixation group has a longer duration of surgery. There is no significant difference in intraoperative blood loss between the two groups (p=0.12). There are no significant differences in VAS scores between the two groups on the 3rd day, 7th day, and 1st and 3rd month after surgery (p=0.77; p=0.06; p=0.32; p=0.56). No statistically different between the two groups at hip Harris scores on the 3rd and 6th month after surgery (p=0.39; p=0.27). There are no complications such as wound infection, internal fixation failure, and periprosthetic fracture. It is concluded that the short-term follow-up study finds that ZNN and InterTan intramedullary nails can achieve satisfactory results in the treatment of intertrochanteric fractures in the elderly. However, InterTan intramedullary nails have complicated operation steps and long operation time. Therefore, ZNN intramedullary nails are recommended for patients with poor surgical tolerance.