Various modalities of treatment of intertrochanteric are available which includes extramedullary devices like DHS and intramedullary nails like PFN, PFNA, TFN, GAMMA nail. Present study was aimed to compare Harris hip score in proximal femoral nail with augmentation and proximal femoral nail without augmentation in unstable intertrochanteric femur fracture treated in adults at a tertiary hospital. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients > 20 years age, either gender, admitted with unstable inter-trochanteric femur fractures amenable to osteo- synthesis by Proximal Femoral Nailing, Patients allocated as Patients operated with proximal femoral nail with augmentation using SS wire - Group A & Patients operated with proximal femoral nail - Group B . Results: Age, gender, mode of trauma & co-morbidities were comparable among both groups. In group A, patient had Harris hip score of 0 on day of trauma, mean score of 69.57 ± 4.78 on 1st month , mean score of 75.71 ± 4.63 on 3rd month and mean score of 85.85 ± 2.87 on 6th month with F-value of 2076.13 and P-value of less than 0.0001.. In group B, patient had Harris hip score of 61.29 ± 5.60 on 1st month, mean score of 72.35 ± 4.07 on 3rd month and mean score of 78.23 ± 2.33 on 6th month with F-value of 1812.81 and P-value of less than 0.0001. Conclusion: Osteosynthesis with proximal femoral nail with augmentation in unstable intertrochanteric femur fracture in the adult patients leads to better functional outcomes as compared with osteosynthesis with proximal femoral nail without augmentation. Categories: Physical Medicine & Rehabilitation, Orthopedics, Trauma