BACKGROUND This paper evaluates the efficacy and safety of the use of cancellous screw fixation in the treatment of intracapsular femoral neck fractures in our local population. METHODS A retrospective analysis of the results of 116 cases that were performed in Singapore General Hospital and Changi General Hospital over a 2-year period was undertaken. The minimum period of follow-up was 2 years. RESULTS The median age of the study group was 71 years and approximately two-thirds were females. There were 104 (90%) cases of undisplaced (Garden 1 and 2) fractures and 12 (10%) displaced (Garden 3 and 4) fractures. The specific complication rate was much higher in the displaced group of patients. At 2 years' postoperation, 85% returned to their premorbid level of ambulation and 90% reported good pain relief. The 1-year mortality rate was 7%. CONCLUSIONS Cancellous screw fixation is a relatively safe and useful operation. It achieved our aim of returning most patients to their pre-fracture level of ambulation and providing good pain relief.