OBJECTIVE To evaluate the clinical effect of cannulated screw on treatment of femoral neck fracture (FNF). METHODS Forty-two FNF patients were treated by using cannulated screw from January 2001 to December 2005. There were 22 males and 20 females with an average age of 41 years (19-59 years). Fracture was caused by traffic accident in 21 cases, by falling from height in 14 cases and by bruise in 7 cases. All cases were fresh fracture. According to Garden criterion for typing, 15 cases were classified as type I , 16 cases as type In and 11 cases as type IV. It was 7 hours to 15 days from injury to operation. RESULTS The patients were followed up for 1-6 years with an average of 2.5 years. The average fracture union time was 6.5 months. Three patients had ischemic necrosis of femoral head, and loosening and breakage of screw and rob was observed in 1 case. According to Brumback criterion for hip joint function, the result was excellent in 18 cases, good in 20 cases and bad in 4 cases, and the excellent and good rate was 90.4%. CONCLUSIONS Cannulated screw fixation is a good method to treat FNF in young adults. It can improve the rate of fracture union and reduce the rate of avascular necrosis of femoral head.