Background The aim of this study was to compare the clinical results between double reverse traction repositor and traction table used for the treatment of unstable intertrochanteric femur fracture. Methods This retrospective study included 95 patients with AO/OTA 31- A2 and A3 proximal femur fracture, who underwent double reverse traction repositor or traction table facilitated Asian proximal femoral nail antirotation (PFNA-II) nailing. The demographics, duration of operation, blood loss, part loading time after surgery, the period of union of fracture, complication were assessed. Clinical and radiological outcomes were evaluated. Results There were no significant differences in respect to demographics and fracture characteristics. Duration of patient positioning and total operative time were significant longer in traction table group than that in double reverse traction repositor group(p<0.001). No differences were found intraoperative blood loss, part loading time after surgery, fracture healing time and Harris Hip Score between two groups. Conclusion When treating unstable intertrochanteric fractures, double reverse traction repositor is superior to tract table in respect to operative time and duration of patient position, despite an additional ipsilateral anterior superior iliac spine (ASIS)incision and drilling of ASIS and femur condyle.