〔Abstract〕 Objective To explore the clinical efficacy of parathyroid hormone (1-34) combined with hollow nail in elderly patients with femoral neck fracture combined with osteoporosis. Methods A total of 80 elderly patients with femoral neck fracture combined with osteoporosis admitted to Jiyuan People's Hospital from July 2020 to July 2021 were randomly divided into an observation group and a control group, with 40 patients in each group. The control group was treated with hollow nailing, and the observation group was treated with parathyroid hormone (1-34) combined with hollow nailing. Fracture healing time, discharge time, pain score, hip function score, bone density level and quality of life score were observed and compared between the two groups. Results Fracture healing time and discharge time in the observation group were shorter than that of the control group, pain score was lower than that of the control group, hip function score and bone mineral density level were higher than that of the control group, the differences were statistically significant (P < 0.05). Conclusion Parathyroid hormone (1-34) combined with hollow nail therapy can obtain better clinical efficacy in elderly patients with femoral neck fracture complicated with osteoporosis. Compared with hollow nail therapy alone, the recovery time of patients is shorter, the pain symptoms are significantly relieved after treatment, and the hip function and bone mineral density level are improved.