Proximal femoral fractures are rare in children; however, they are associated with a high rate of complications. They are the consequence of high energy trauma following motor vehicle accidents and falls from greater heights. The ideal treatment for displaced fractures should include anatomical reduction and stable fixation, if possible within 24 hours from the trauma in order to reduce the incidence of sequelae. Adequate fixation may be obtained using Kirschner wires, cannulated screws, plates and screws or external fixators, depending on the type of fracture. Complications include avascular necrosis of the femoral head, coxa vara, nonunion, premature physaeal closure and limb discrepancy.