Despite the general success of the sliding hip screw for stabilization of intertrochanteric fractures, there is dissatisfaction with the resultant deformity associated with its use, particularly in unstable fracture patterns. These concerns have resulted in increasing use of intramedullary devices for treatment of peritrochanteric fractures. Use of an intramedullary device for peritrochanteric fracture stabilization limits the amount of lag screw sliding and resultant limb deformity, particularly shortening, since the fracture can settle only until the proximal fragment abuts against the nail. This article describes some of the advances in intramedullary nails used to stabilize peritrochanteric fractures.