The morbidity and mortality are reduced in elderly trochanteric fracture patients by using Ender nails under image intensifier. This showed several advantages such as minimal trauma, short operation time, little blood loss, early ambulation and low infection rate. But there are some complications of Ender nail, because of difficulties in operative techniques and severe osteoporosis and instability of elderly trochanteric fracture. So, many efforts have been made to reduce these complications. The authors treated 34 cases of trochanteric fractures of the femur during the period from September 1987 to May 1991 with Ender nail. The results were as follows; l. Among 34 cases, 11 cases were male and 23 cases female and average age was 73. 2. The most common complication was knee pain (12 cases) and others were knee stiffness, migration of nails and leg shortening in orders. 3. The operative technical problems and errors were retrieval of the nails, too long or short nails, too far anterior position of the portal holes, penetration of distal femoral cortex, failure of filling nails enoughly in medullary canal and difficulty in passing the nails across the fracture site and properly positioning in femoral head. 4. These complications were reduced by careful selection of nails of appropriate length, fan-shaped placement of nails in femoral head, stacking the nails in femoral canal to prevent migration, accurate placement of portal holes and anteversion bending at the tip of nails. 5. If these complications were reduced by operative technique and the indications of Ender nail were properly selected, the result of treatment of elderly trochanteric fractures with Ender naill was satisfactory.