The aim of the present study was to answer the question whether or not a hemiarthroplasty has a place in the treatment of pertrochanteric femur fractures for elderly patients. At the Kantonsspital Baden 80 hemiarthroplasties were implanted in 76 patients for pertrochanteric femur fractures from 1988 to 1993. The average age of the patients was 82 years (SD 7.5 years). The operating time, the blood loss and the cement reactions were obtained retrospectively from charts. The long term result was assessed with the clinical score of Merle d'Aubigne and Postel. At the time of follow-up 46 patients (60%) were deceased. The mean survival time of these patients was 58 weeks, ranging from 0 to 326 weeks. The review of the records showed a significantly poorer general health preoperatively (mean ASA score 2.7) compared to the survivors (mean ASA score 2.2). There was, however, no increased complication rate, blood loss or cement reaction found. The remaining 30 patients were available for clinical examination (n = 25) or could be interviewed by telephone (n = 5) after an average follow-up of 165 weeks, ranging from 1 to 6 years. The score of Merle d'Aubigne and Postel showed a nearly painfree hip joint (mean score 5) with a good mobility (mean score 5). The walking ability was reduced due to the advanced age (mean score 3). A painful hip was found in 6 patients (20%). At the time of review no hemiarthroplasty had to be converted into a total hip replacement. It is concluded that the hemiarthroplasty guarantees a primary stability without an increased operative risk and a low complication rate. We regard the hemiarthroplasty as a good alternative to DHS and Gamma-nail for the treatment of pertrochanteric fractures for elderly patients.