BACKGROUND: The PerCutaneous Compression Plate (PCCP) was developed by Gotfried (Israel, Haifa) for minimal-approach osteosynthesis of pertrochanteric fractures. METHODS: One hundred fifteen patients, aged 60 or more, with intertrochanteric fractures (AO type 31A1 or 31A2) were selected randomly for fixation with either the PCCP (53 patients) or the Dynamic Hip Screw (62 patients). All surviving patients were scheduled for a 1-year follow-up. RESULTS: Less invasive surgical stabilization of pertrochanteric fractures with the PCCP resulted in shorter theater and surgical time and reduced postoperative pain. The PCCP treatment showed a tendency toward a lower transfusion need and a reduction of fracture impaction; however, results were not statistically significant. There was a trend toward a higher mechanical complication rate with the PCCP: anatomic closed reduction without posterior sagging of the fracture and fluoroscopic control of the placement of the first neck screw in two directions are essential to avoid technical complications. CONCLUSION: Minimal invasive treatment of pertrochanteric fractures with the PCCP reduces operation time and postoperative pain.