Objective To explore the feasibility and the curative effect of proximal humeral nailing in the treatment of elderly proximal humeral fracture. Methods From January 2015 to December 2016, 49 cases above 70 years old with elderly proximal humeral fracture (NeerⅡ-Ⅳ)were included and reviewed.All cases were divided into 2 groups according to different internal fixation and treated with locking proximal humeral plate (LPHP group) or intramedullary proximal humeral nailing fixation (IPHN group) respectively. The comparability of the basic data of two groups, recovery of shoulder joint function and imaging data were analyzed. Results The difference was considered statistically significant between two groups in the assessment during the early postoperative period(P<0.05).There was no significant difference in the assessment of long-term function after operation(P>0.05).And there was no significant difference in the assessment of cure rate between the two groups (P>0.05). Conclusion IPHN may promote the early recovery of elderly proximal humeral fracture, but its long-term effects have no obvious advantage.