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Objective: To compare the clinical curative effect of total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) on the treatment of senile femoral neck fracture for elderly patients. Methods: 90 elderly patients with femoral neck fracture who were treated in our hospital from July 2013 to March 2015 were selected, and according to the different treatment methods, the patients were divided into the total hip arthroplasty group (THA) and the bipolar hemiarthroplasty group (BHA), with 45 cases in each group. Then the operation time, the intraoperative blood loss, the hospitalization, the incidence of postoperative complications and the clinical effects in the two groups were observed and compared. Results: There was no statistically significant difference about the operation time, the intraoperative blood loss and the hospitalization of the patients in the two groups (P>0.05); The incidence of postoperative complications in the THA group was lower than that of the BHA group (P<0.05); There was no statistically significant difference about the clinical effects in the two groups after the treatment for one year (P>0.05); The clinical effects in the THA group after the treatment for two and three years were significantly higher than those of BHA group, and the differences were statistically significant (P<0.05). Conclusion: THA and BHA have a good clinical efficacy on the treatment of senile femoral neck fracture for elderly patients, and THA is better for a long-termcurative effect and lower postoperative complications. [ABSTRACT FROM AUTHOR]