Subtrochanteric fractures have been prone to nonunion and implant failure following internal fixation due in part to the high level of stress applied regularly to that area of the femur. A classification of these fractures based on current treatment options is offered. The use of intramedullary nails is encouraged for treatment of subtrochanteric fractures whenever possible. Recent studies have demonstrated improved results with the use of intramedullary nails when the fracture pattern will allow.