The purpose of the current study was to present the authors’ experiences with the long intramedullary Gamma nail in the treatment of patients with complex femoral fractures. Th is retrospective study included 48 patients with complex femoral fractures. All patients had received fracture fixation treatments with long intramedullary Gamma nails from January 2007 to December 2015. The complex fractures of all patients were classified into 3 types, according to the anatomical locations of the fractures. Type I included combined fractures of the shaft and the proximal femur. Type II included segmental fractures. Type III included combined fractures of the shaft and distal femur. According to the Harris Hip Score, 85.4% of our patients had excellent and very good functional outcomes of the operative procedure. Complications occurred in 7 (14.58%) patients. The most common complications occurred in patients with combined fractures of the shaft and distal femur (50%). Based on the findings of this study, we conclude that the clinical and radiological results after the treatment of complex femoral fractures with the long intramedullary Gamma nail show good outcomes, with a high rate of bone union and minimal soft tissue damage. Experience with this procedure is important to prevent and minimise technical complications.