PURPOSE: We tried to evaluate the usefulness of the cementless Zweymuller stem for treating hip fracture in those patients older than 80 years with severe osteoporosis. MATERIALS AND METHODS: Thirty cases were treated with bipolar hemiarthroplasty with a cementless Zweymuller stem and they served as group I (the study group), and 30 cases treated with a cemented stem served as group II (the control group). We performed a comparative study between the two groups. RESULTS: The admission period (days) was 24.6+/-10.7 and 32.8+/-16.8 (p=0.047) for the 2 groups, respectively, and the average operation time (minutes) was 75.8+/-17.6 and 89.2+/-28.1 (p=0.024), respectively; the total blood loss (ml) was 457.2 and 548.3 (p=0.035) in group I and II, respectively. The incidence of staying in the intensive care unit (ICU) and the average time to start postoperative ambulation showed no significant differences between the two groups. Pulmonary embolism occurred in 1 case in group I and in 4 cases in group II, and intraoperative fracture of calcar occurred in 2 cases of group I. There was no case of position change of the femoral stem at 1 year postoperatively in both groups. CONCLUSION: The cementless Zweymuller stem, inserted by press fit in the patients who are older than 80 years and who have hip fracture with severe osteoporosis showed clinically better results as compared with the cemented stem.