Aims: Review the results of Long Gamma nail in the treatment of a select group subtrochanteric meta-static lesions of femur. Methods: From 1996 to 2002, 34 patients with subtrochanteric metastatic lesions of femur treated with Long Gamma Nail were included in this retrospective study. Hospital records and x-rays were reviewed for collecting the data. Results: 37 met-astatic femoral subtrochanteric lesions (3 bilateral) in 34 patients, 17 male and 19 female, with an average age of 65 yrs, had reconstruction with Long Gamma Nail. Right femur was affected in 15 and left in 22. Most common primary cancer was breast in 15, prostrate in 5, lung in 5, and others in 9 cases. Prophylactic nailing was preformed in 28 femurs (75%) and nailing of actual fracture in 9 femurs (25%). All femurs had distal locking bolts except in 2. Postoperatively pain relief was achieved and pre-op mobility was regained in all patients. 5 patients (13.5%) had medical complications including a death due to chest infection. 4 patients (10%) had implant related complications but none required any further surgery. There were no implant failures. From the time of surgery 20 patients (60%) died with a mean survival of 9 months, and 13 patients (40%) are alive, pain free and independent with a mean survival of 18 months. The overall patient survival rates after operation are 73% at 6 months, 56% at one year and 40% at 4 years. Conclusion: Reconstruction of met-astatic subtrochanteric femoral lesions with long gamma nail is highly effective in achieving local pain control, restoring limb function and better quality of remaining life with acceptable rate of complications.