We report the clinical results of 51 peritrochanteric fractures treated with the Gamma nail. There were 6 stable and 45 unstable fractures according to Evans classification. The distal locking screw was used for only 9 of the 51 fractures. The mean duration of surgery was 52 minutes with minimal operative blood loss. Gait recovery for 18 patients followed for over 2 months was satisfactory.Intraoperative complications included jamming of nail (one case), fracture of lateral cortex (one case) and displacement of peritrochanteric fracture (two cases). Postoperative complications included cut out (one case) and migration of lag screw (three cases), nail movement in medullary cavity (two cases), femoral shaft fracture (one case), breakage of distal locking screw (one case) and bone atrophy of femoral shaft (one case). We suggest that these complications might be caused by incorrect intramedullary nail placement, incorrect lag screw placement, distal locking screw problems and osteoporosis.