Background: Per-trochanteric fractures are common in elderly patients, often requiring surgical intervention. The choice of implant plays a critical role in outcomes. This study compares the efficacy of anti-rotational blade implants (ARBI) and two-screw implants (TSI) in the treatment of per-trochanteric fractures. Methods: A prospective comparative study was conducted in the department of Orthopaedics of SCB Medical College, Cuttack on 30 patients with per- trochanteric fractures, divided into two groups: Anti Rotational Blade Implant (n=15) and Two Screw Implant (n=15) from May 2023 to June 2024. Outcomes were assessed based on operative time, blood loss, fluoroscopic time, fracture union time, functional outcomes (Harris Hip Score), and complications. Results: Operative time has an average of 70.33 minutes for Two screw implant. Mean blood loss of 195 ml. Mean usage of image intensifier was 110 seconds. Abductor lurch was seen in one patient. Average union time in weeks is 15.8 weeks. Operative time has an average of 68.6 minutes for Anti rotational blade implant Mean blood loss of 175 ml. Mean usage of image intensifier was 104secsonds. Abductor lurch seen in 1 patient alone. Average union time in weeks is 15.4weeks. From the p-value it was considered that there wereno significant difference in functional outcome for both the implants. Conclusion: Anti-rotational blade implants have no significant difference in terms of operative efficiency, fracture healing, and reduced complications compared to two-screw implants in the treatment of per-trochanteric fractures.