The proximal femur is an anatomically complex region that acts as a lever between the trunk and lower limbs and must be able to sustain forces four times the body weight during a simple activity as normal running. Patients involved in sports may suffer a proximal femur fracture by two different mechanisms: trauma or a repetitive stress injury. Both types of fractures are addressed in this chapter. Traumatic fractures in the proximal femur must be differentiated between femoral neck and trochanteric fractures. Femoral neck fractures may be treated by reduction and fixation or by arthroplasty. The adequate treatment will be customized for each case and dictated by several considerations regarding fracture properties (fracture pattern, displacement, risk factors for nonunion or avascular necrosis) and patient characteristics (age, functional capacity, and comorbidities). Trochanteric fractures must be surgically treated by reduction and fixation. The outcome for the athlete who suffered a trochanteric fracture will be dependent on a proper surgical technique: an adequate reduction and proper positioning of the implant in the femoral neck are pivotal points that must be followed. Femoral neck stress fractures (FNSF) result from a cyclical overload of the femoral neck that creates an unbalance between osteoblastic and osteoclastic activities. It is a common stress injury that exists as a spectrum between incomplete, benign, stable lesions, and displaced fractures. Early diagnosis is a requisite to avoid the devastating complications that may result after a neglected incomplete fracture. High clinical suspicion, an adequate physical examination, and immediate radiological study are essential. Understanding the hip anatomy and biomechanics is imperative to correctly characterize a fracture as stable or unstable and decide between conservative or surgical treatment.