This study evaluated the relationship of the disposition and outcome of patients with displaced femoral neck fractures with the type of surgical treatment. From 1993 to 1996, 186 patients with displaced femoral neck fractures who were 65 years of age or older were treated at one hospital. One hundred and twenty fractures were treated with reduction and internal fixation; 66 were treated with arthroplasty. The time interval from fracture to death and to repeat surgery was significantly less for the internal fixation group than for the arthroplasty group. The possibility of nursing home residence is increased in patients who were treated with reduction and internal fixation compared with patients who were treated with arthroplasty.