Background: Hip fracture is quite common phenomena in old age and leads to multiple consequences because fracture cannot heal hence require proper and ideal technique as Osteoporosis develops in old age so that patients can lead a normal quality of life. Method: Out of 60 patients 30 were inserted Proximal Femoral Nail (PFN) and 30 were internal Proximal nail anti rotation (PFNA). The helical blade whole PFN has two screws one large which stabilizes the fractured part of femur and another one is anti rotation while PFNA has helical blade which provides stability and anti-rotation mobility. Both surgeries are similar but instrumentation and techniques differs. Results: In the comparison study. The mean value of duration of time was 41.2 (SD±6.10) in PFN and 34.18 (SD±5.03) in PFNA t test 4.9 and p<0.01. Mean value of loss of Blood (ml) was 75.7 (SD±15.35) in PFN, 58.4 (SD±12.96) in PFNA t test 4.73 p<0.01. Fluoroscopy images mean values 27.5 (SD±3.48) in PFN, 16.3 (SD±3.10) in PFNA t test p<0.001 of cut out/ z-effect was 3 (10%) in PFN, 1 (3.3%) in PFNA Reoperations were 3 (10%) in PFN and 1 (3.3%) in PFNA. Loss of reduction study has shortening > 1 cm was 5 (16.6%) in PFN and 3 (10%) in PFNA, varus mal alignment was (10%) in PFN, 1 (3.3%) in PFNA, In the outcomes of both techniques mortality was 3 (10%), 2 (6.6%) in PFNA persistent pain was 5 (16.6%) in PFN, 4 (13.3%) in PFNA, use of walking aids 10 (33.3%) in PFN, 7 (23.3%) in PFNA. Return to pre-fracture status, 17 (56.6%) in PFN, 19 (63.3%) in PFNA Harris hip score was more or less similar. Conclusion: PFNA significantly reduces duration of time, loss of blood, Fluoroscopy imaging, Mortality rates. Hence PFNA is better option in osteoporotic (aged patients).