Objective: To evaluate preliminary results of senile unstable femoral intertrochanteric fractures with the Mallory- Head prosthesis of primary total hip arthroplasty. Methods: From August 2010 to December 2012, a retrospective analysis that the treatment of senile unstable femoral intertrochanteric fractures with the Mallory-Head prosthesis of primary total hip arthroplasty in 16 cases was performed. There were 4 males and 12 females with age ranging from 72 to 91 years old (mean 79). Results: Operation time was from 45 to 65 min (mean 52 min), the amount of bleeding was from 140 to 350 mL (mean 180 mL); the hospital stay was from 14 to 19 d (mean 15 d). None of the patients got incision infection. According to the standards of Engh, 16 cases of Mallory-Head prosthesis were osseous fixed; Harris score is 65~91 points (mean 87.8), excellent in 13 cases, good in 3 cases, and bad in 1 case. Conclusion: The surgical techniques of senile unstable femoral intertrochanteric fractures treated with the Mallory-Head prosthesis of primary total hip arthroplasty is safe and effective, the patient can walk in early stage and improve the quality of life.