Background: Intertrochanteric fractures are prevalent among the elderly, often due to osteoporosis, lead-ing to significant morbidity. The Proximal Femoral Nail Anti-rotation II (PFNA-II) has been introduced to improve fixation stability and reduce complications associated with traditional methods. Methods: A single-arm interventional study was conducted on 35 patients aged 40–80 years with intertro-chanteric femur fractures treated using PFNA-II at Gulbarga Institute of Medical Sciences, Kalburgi, from August 2022 to January 2024. Patients were followed clinically and radiologically at regular intervals. Functional outcomes were assessed using the Harris Hip Score at 3 and 6 months postoperatively. Results: The mean age of patients was 64.17 years, with a slight female predominance (51.42%). Most fractures resulted from trivial trauma (71.42%). The average duration of surgery was 30.37 minutes, and mean blood loss was 117 ml. Fracture union was achieved in an average of 13.74 weeks. Complications included superficial infection in 3 patients and helical blade cut-out in 1 patient. At 6 months, 54% of pa-tients had an excellent outcome, 28% good, and 17% fair, according to the Harris Hip Score. Conclusion: PFNA-II is an effective implant for treating intertrochanteric femur fractures, offering re-duced operative time, minimal blood loss, and favourable functional outcomes. It may be considered a biomechanically superior option for unstable intertrochanteric fractures.