Purpose <p>To discuss the use of intramedullary nailing in the treatment of proximal humeral fractures in the elderly.</p> Method <p>Review of the existing literature on intramedullary nailing of proximal humeral fractures in the elderly.</p> Results <p>Intramedullary nailing of proximal humeral fractures as minimal invasive technique has certain advantages in view of soft tissue damage, blood loss and operation time. On the other hand it might not be the ideal solution for more complex fracture types.</p> Conclusion <p>Intramedullary nailing of proximal humeral fractures in the elderly is a valid treatment option with some advantages compared to plating. However operative treatment of these fractures still has a large re-operation rate compared to non-operative treatment.</p>