Abstract:[Objective] To evaluate the clinical outcomes of F-shaped cannulated lag screws placement for internal fixation of Pauwels type III femoral neck fracture. [Methods] A total of 96 patients received closed reduction and internal fixation with 3 cannulated lag screws for Pauwels type III femoral neck fracture in our hospital from May 2017 to March 2019. Among them, 50 patients had the screws placed in “F” shape, while the other 46 patients had the lag screws inserted parallelly. The documents regarding to perioperative period, follow-up period and radiographs were compared between the two groups. [Results] All patients in both groups were successfully operated on without serious complications. There were no significant differences in operative time, incision length, intraoperative blood loss and length of hospi- tal stay between the two groups (P＞0.05) . All the patients were followed up for 12~32 months, with an average of (15.52±3.41) months. The VAS score decreased significantly, whereas hip extension-flexion range of motion (ROM) and Harris score increased significantly over time postoperatively in both groups (P＜0.05) , which in the F-shaped group was significantly superior to the parallel group at the latest follow up (P＜0.05) . Radiographically, the F- shaped group proved significantly superior to the parallel group in term of fracture reduction quality measured by Garden alignment index and fracture healing time revealed radiographically (P＜0.05) . [Conclusion] The F-shaped placement of cannulated lag screws for internal fixation of Pauwels type III femoral neck fracture does improve the quality of fracture reduction, in- crease the stability of fixation, and is benefit for functional recovery.