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Objective: To study the effect of reserving articular capsule and traditional total hip replacement for old patients with unstable femoral neck fractures., Methods: From January 2010 to January 2015, one hundred and twenty patients with femoral neck fracture were retrospective review. Among them, sixty patients were treated with total hip arthroplasty reserving articular capsule, the others were treated with traditional total hip arthroplasty without reserving articular capsule. The gender of reserving articular capsule group and traditional group were (male/female) 34/26, 31/29 respectively; the age were (73.4±4.4), (72.3±4.1) years old, respectively. All patients were followed up for six months, the operation time, blood loss, length of stay, incidence of postoperative complications, incidence of postoperative hip dislocation and hip Harris score of the two groups were observed., Results: The operative time of the reserving articular capsule group and traditional group were (95.68±6.90), (93.39±7.90) min ( P >0.05), and the blood loss were (998.78±15.20), (1 000.25±16.80) ml ( P >0.05). The time for hospital stay were (10.74±2.90), (13.25±2.20) days( P <0.05). The Harris scores were 58.53±5.10, 49.38±4.90( P <0.05) at 1 month after operation;91.08±7.50, 90.74±7.10( P >0.05) at 6 months after operation., Conclusions: The method of reserving auricular capsule can not increase the operative time and the blood loss. But it has a favorable effect on decreasing the hospital stay, complication, the rate of early dislocation of the hip joint, improving the function of hip joint., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.