〔Abstract〕 Objective To investigate the effect of the timing of proximal femoral nail antirotation (PFNA) on postoperative blood loss in elderly patients with intertrochanteric fracture of femur (IFF). Methods A retrospective analysis was made of 54 elderly patients with intertrochanteric fracture of the femur admitted to Foshan First People's Hospital from January 2018 to January 2021. According to the time of operation, they were divided into 11 cases in the early group (operation within 1~2 days after injury) and 43 cases in the delayed group (operation within 3~7 days after injury). Record the height, weight and age of the two groups of patients at the time of admission, the time between injury and surgical treatment, and the operation time; The levels of hematocrit (Hct), hemoglobin (Hb) and erythrocyte count (RBC) before and 1 and 3 days after operation, as well as the occurrence of postoperative complications. The total red blood cell loss, total blood loss and postoperative Hct difference were calculated to evaluate the blood loss of patients during the perioperative period. Results The total red blood loss, total blood loss and postoperative Hct difference in the early group were lower than those in the delayed group, and the operation time in the delayed group was longer than that in the early group, the differences were statistically significant (P < 0.05). There was no significant difference in the incidence of complications between the delayed group and the early group (P > 0.05). According to the days from injury to operation, the patients were divided into 7 groups (1 ~ 7 days). Kruskal-Wallis test showed that the difference of total blood loss among different groups (1 ~ 7 days) was statistically significant (χ 2 = 13.512, P = 0.036). Conclusion Early surgical treatment in elderly IFF patients can reduce postoperative blood loss and the incidence of postoperative complications, and promote the recovery of hip function more effectively.