PURPOSE: This retrospective study was performed to know the difficulties and efficient methods of treatment after several types of operations for ipsilateral femoral neck and shaft fracture. MATERIALS AND METHODS: Thirteen cases (12 patients) with ipsilateral femoral neck and shaft fracture at the mean age of 36.6(range 21-51), have been followed up over the minimum of one year. All the patients suffered from motor vehicle accidents(11 in dash-board injury), and most of patients associated with multiple injuries including other fractures. All of femoral neck fracture were same type in basicervical area and 4 of them were missed initially. According to the classification of femoral shaft fractures, middle 1/3 fracture was most common in 10 cases and type C in 8 cases. In neck fractures, all cases were treated with multiple pinning, but in shaft fractures, 6 were treated by open plating, 5 by closed antegrade nailing, and 2 by retrograde nailing. RESULTS: The mean union period was 12.1 weeks in neck fractures and 9.9 months in shaft fractures. In complications, there were 1 case of nonunion and 1 case of avascular necrosis in neck fractures, and 8 of delayed union, 3 of nonunion, and 2 of malunion, in shaft fractures. The methods of treatment had no influence on the results of this injury, but we had 1 failure in antegrade nailing prior to operation of neck fracture. CONCLUSION: After operation of ipsilateral femoral neck and shaft fracture, the shaft fracture needed longer time of union and had many problems in spite of different methods. We suppose that many problems in shaft are affected not only by characteristic mechanism of injury, but also by multiple associated injury.