Femoral neck fractures are intracapsular hip fracture which are common in elderly patients.The common modality of treatment of neck of femur fracture in elderly patients are hemi replacement (HRA) and total hip arthroplasty (THR). A comparative study in 42 patients aged more than 65 years with neck of femur fracture taken up for surgery and treated with HRA and THR and post operatively mobilisation was encouraged on first day after surgery and full weight bearing ambulation with waking aids. Follow up evaluation was done at 2,4,8,12 weeks using Harris hip score Visual analogue scale. 42 patients divided into two groups of 21 each. With mean age of 72.19 in group A and 65.86 in group B.Where group B show statistically significant P value in term of VAS score and HHS. Group B showed better functional recovery (higher Harris Hip Scores), quicker pain relief, and faster discontinuation of walking aids. Both groups had similar early postoperative mobilization. Overall, Total Hip Arthroplasty led to improved recovery and outcomes compared to Hemiarthroplasty. In our study we concluded that THR is a better option as compared to HRA in the management of elderly patients with neck of femur fracture on account of short term functional outcome, less complication rate and higher Harris hip score.