Aim: This study evaluated the complication rate and surgical outcome following medial femoral neck fractures, in elderly patients over 75 y, treated by biarticu-lar endoprosthesis. Methods: We followed prospectively 100 patients over 75 years old consecutively operated in our department of clinical orthopaedics at Catholic University of Rome for subcapital femoral fractures graded as Garden 3 or 4. In the study were also included patients affected by senile dementia and Parkinson disease. Patients were operated on by several surgeon of different experience in the þeld, we evaluated the time needed for the intervention, blood loss, survival rate at 1 months. Outcome was evaluated on the basis of walking recovery rate and pain. Bed ridden patients were evaluated only for residual pain after surgery. Results: Mean time interval between trauma and surgery has been 3,96 days. The intervention lasted 45 minutes in average (range 35 Ð 70 minutes). Blood loss has been limited. Return to walking with assistance has been achieved in fourth postoperative day. Pain disappeared in almost every patient. Dislocation of prosthesis was observed in 2 patients. Survival rate at one month was 89%.,Conclusions: Biarticular endoprosthesis in our experience demonstrated to be an effective mean for treatment in the elderly patients and above all in the neurological patients.