A cadaveric study was done to determine the relationship of intramedullary axis of femur and the anatomical landmarks of proximal femur. The sharp tipped intramedullary rod was placed in the medullary canal from the isthmus to the proximal femur in 20 adult femoral specimens. The point of exit was measured in relationship to the piriformis fossa, tip of greater tuberosity, and mid lesser tuberosity. The center of the femoral canal axis is 1.23 ± 0.92 cm superior and medial to the pirifomis fossa, and is located 1.55 ± 0.66 cm from greater tuberority and 5.21 ± 1.28 cm from mid lesser tuberosity. The clinical relevance of this study is that the starting point for closed antegrade intramedullary rod of the femur should be 1.2 cm superior and medial to piriformis fossa in order to avoid the difficulty and complications in intramedullary nailing.