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Inter trochanteric Fractures in elderly is a common fracture and having a very high mortality and morbidity. With life expectancy is increasing across the world due to better medical facilities apart from other reasons too, we have large chunk of elderly population who need healthcare. With increase in the elderly population, their problems are also increasing especially in regard to the osteoporotic fractures they sustain. Almost one in 3 women and one in 5 men sustain these types of fractures in their later life. With the availability of modern investigation procedures like CT scan and 3D CT reconstruction, as treating surgeons, we are in a better position to understand the fracture pattern and tackle the same during surgery. The failure in hip fracture fixation is mainly due to unstable fracture and a sub optimal fixation on this high demand area. The outcome result mainly depends upon how robust is our fixation and how early we can make them stand again on their feet. Here is an attempt of me to share a variety of such hip fractures how I have tackled to get a good fixation on table.