Pertrochanteric fractures of the femur are very common in the elderly. The elderly population is increasing steadily, making treatment of these fractures increasingly important in terms of medical, social, and economical issues. Reduced operation time and blood loss, sound stabilization with early mobilization, and reduced in-patient hospitalization time has favored Gamma nail as a first choice of option of surgical treatment of peritrochanteric hip fractures [1, 2] The gamma nail combines the biomechanical advantages of a sliding hip screwwith those of an intramedullary nail. The sliding hip screw provides a controlled impaction of the fracture, thus increasing fracture stability and decreasing bone healing time. The intramedullary nail sits nearer to the weightbearing axis, reducing the bending stresses up to 30 % [3] Despite the widespread use of the gamma nail and its biomechanical advantages, there are reports of implant failure even though this has been thought to be relatively rare. This article presents two cases of implant breakage at the level of the aperture of the lag screw and a thorough review of the literature regarding this rare but devastating complication. To our knowledge, this is the only report in English-language literature of the breakage of the third-generation gamma nail. Case 1