Objective To compare and assess the treatment of intertrochanteric fractures by proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS). Methods Retrospective analyzed 124 patients of intertrochanteric fractures from January 2008 to December 2014 who were received internal fixation with DHS (DHS group, 60 cases) and PFNA (PFNA group, 64 cases). The operation time, length of incision, bleeding, the occurrence rate of complications, bony healing times, and Harris hip scores function at 1 year  after operation were evaluated and compared. Results The mean operation time, length of incision, bleeding of two groups in DHS group were (87±4) min, (14.5 ± 0.6) cm, (150 ± 3) ml, PFNA group: (62 ± 3) min, (7.8 ± 0.4) cm, (100 ± 2) ml respectively. There were significant difference between two groups (P < 0.05). In the study, 58 cases of PFNA group and 53 cases of the DHS group were followed-up, all the fracture healed well. The mean healing time in DHS group in (14.2±0.6) weeks, PFNA group (12.4 ± 0.4) weeks, and there were no significant difference between two groups (P > 0.05). In DHS group, deep hematoma occurred in 2 cases, the reduction was unsatisfactory in 3 cases, knifing of screw occurred in 2 cases. The complication occurrence rate was 13.2%. While in PFNA group, there was 1 case with deep hematoma, 2 cases with unsatisfactory reduction, 2 cases with split fracture and 1 case with knifing of screw. The occurrence rate of the complication was 10.3%. There was no significant difference between two groups (P > 0.05). According to one year Harris hip scores, the excellent cases were 32, good cases were 15, the excellent and good rates were 88.7% in DHS group, while in PFNA group, the excellent cases were 37, good cases were 14, the excellent and good rates were 87.9%, there was no significant difference between two groups (P > 0.05). Conclusions The clinical effect is true and perfect in the treatment of intertrochanteric fracture by DHS and PFNA. PFNA has the advantage of less damage, and it is a more effective method for the treatment of intertrochanteric fractures.