Unstable intertrochanteric fractures in osteoporotic bones of elderly patients was a real challenge that face orthopedic surgeon because of difficult anatomical reduction, poor bone quality and complication of prolonged bed redden or limited ambulation. The aim of study was to assess the clinical outcome of cemented bipolar as primary management of comminuted intertrochanteric fracture femur in elderly Sudanese patients. Material and methods: (30) Elderly Sudanese patients with unstable intertrochanteric fractures (kyle type III or IV) treated by primary hemiarthroplasty using a cemented bipolar prosthesis. Suture or wire fixations were used for reconstruction of greater trochanter fracture. Harris hip score was used for the clinical evaluation. Result: There was a significant relation between age and kyle classification (p value 0.05). According to Harries hip score 17 out of 30 had a good to excellent result (56.7 %) If the patients with a fair result were also included, the percentage goes up to (93.4%). Conclusion: The primary cemented bipolar hemiarthroplasty in unstable intertrochanteric fracture in elderly patients' dose provide staple, pain free with early mobilization, better range of motion and less complication rate in short term follow up.