Background and Objectives: Subtrochanteric femur fractures are among the most challenging injuries for orthopedic surgeons. In elderly patients, they typically result from trivial falls while standing or walking, whereas in younger individuals, road traffic accidents are the predominant cause. Closed management of these fractures is often difficult due to challenges in achieving and maintaining reduction, making operative treatment the preferred approach. This study aims to evaluate the effectiveness of intramedullary fixation using a long proximal femoral nail for subtrochanteric fractures and to analyze the associated complications.Methodology: This prospective study included 25 cases of subtrochanteric fractures admitted to KMC &RI HUBLI DHARWAD between DECEMBER 2022 and MARCH 2025. All cases were selected based on inclusion and exclusion criteria, involving fresh subtrochanteric fractures in adults. Excluded from the study were pathological fractures, multiple fractures, fractures in children, and old neglected fractures. All patients underwent surgical fixation using a long proximal femoral nail.Results: Among the 25 cases, 23 were male and 2were female, with an age range of 18 to 75 years. The majority of patients (67%) sustained fractures due to road traffic accidents, followed by 23% from falls from height and 10% from trivial falls. The right side was more commonly affected. Seinsheimer Type IIIA fractures were the most prevalent, accounting for 36% of cases. The mean hospital stay was 1 week, and full weight-bearing was achieved at an average of 12 weeks. In our study, 80% of cases showed good-to-excellent outcomes.Conclusion: Based on our findings, the long PFN is a reliable implant for treating subtrochanteric fractures, providing a high rate of bone union with minimal soft tissue damage. Intramedullary fixation offers significant biological and biomechanical advantages; however, the procedure is technically demanding. A gradual learning curve and patience are essential to achieving truly minimally invasive outcomes.