Fracture of the proximal humerus occur more frequently in the elderly patients but are seen in all ages. The objectives of treatment are anatomical reduction and restoration of normal function. In recent years, there had been a tendency to advocate operative treatment as the method of choice for certain fractures of the proximal humerus. However, the management of this fracture is still under debate in the elderly patients. After clinical analysis of 71 cases of proximal humeral iractures, the followings were obtained. The results of treatment were influenced by several factors, osteoporosis in the elderly and the degree of the comminution. Therefare, the results in the elderly with osteoporosis was more poor than those of the younger patients. The results in three among four cases of four-part fracture was poor in spite of operative management. So we recommend conservative treatment initially or minimal osteosynthesis in the treatment of four-part fractures. In fact, the patients showing poor results were complicated with shoulder joint stiffness respectively.