Introduction: Femoral neck fractures present significant challenges in clinical treatment, with prognosis often being uncertain. At present, no single internal fixation method has proven to be superior to others for managing these fractures. As a result, there is a need for further investigation into different internal fixation systems. This study aims to compare the clinical outcomes of using a dynamic hip screw system versus multiple cannulated compression screws for treating femoral neck fractures. Methods: This randomized controlled trial was carried out in the Department of Orthopedics at GMERS, Valsad. Results: Six months post operatively, Harris Hip Score evaluations indicated that the Dynamic Hip Screw (DHS) was a superior implant compared to the cannulated screws. The DHS group experienced one fixation failure, while the cannulated screw group had three failures. Additionally, surgeries using cannulated cancellous screws were associated with significantly shorter operation times, reduced radiation exposure, and lower blood loss. Conclusion: The findings of this study support the hypothesis that the Dynamic Hip Screw (DHS) is a superior implant compared to cannulated cancellous (CC) screws for managing femoral neck fractures in young adults with Pauwels type II and III fractures, particularly in terms of functional outcomes. While the complication rate does not appear to be influenced by the choice of implant, a longer follow-up is needed to further validate these results. Despite DHS being associated with longer surgery duration, increased radiation exposure, higher blood loss, and a higher infection rate, it provides better outcomes in terms of radiological union and functional status compared to CC screws.