〔Abstract〕 Objective To investigate the effect of different nail lengths in the treatment of intertrochanteric fracture of proximal femoral intramedullary nail (PFNA). Methods A total of 102 patients with intertrochanteric fractures admitted to Luoyang Third People's Hospital from January 2019 to March 2021 were selected, and they were divided into the short nail group with 52 cases and the long nail group with 50 cases according to the length of the main nail. The short nail group used 170 mm internal nail, and the long nail group used 200 mm internal nail. The total effective rate, operation index, hip joint function score and complications were compared between the two groups. Results The total effective rate of the short nail group was 96.15% (50/52), which was higher than 94.00% (47/50) of the long nail group, and the difference was not statistically significant (P > 0.05). There was no significant difference in the blood transfusion rate, hospitalization days and bone healing time between the two groups (P > 0.05). The hip function score of the two groups after operation was higher than that before the operation, the difference was statistically significant (P < 0.05). The complication rate of the short nail group was 5.77 %, lower than 8.00 % of the long nail group, and the difference was not statistically significant (P > 0.05). Conclusion PFNA has good efficacy in the treatment of intertrochanteric fracture with short nails and long nails, and can promote the recovery of patients' hip function. However, short nails have better efficacy and can reduce the rate of blood transfusion and the incidence of complications.