Background: Intertrochanteric fractures of the femur are common hip fractures, particularly among elderly patients with osteoporotic bones, and are associated with substantial morbidity and mortality due to prolonged immobilization and related complications. Therefore, this study aimed to compare the functional outcomes of intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS). Methods: This comparative observational study was conducted at the Department of Orthopaedic Surgery, Uttara Adhunik Medical College, Dhaka, Bangladesh, and selected private clinics within and outside Dhaka, from July 2024 to June 2026. Forty patients were included, with 20 treated by PFNA and 20 by DHS. Functional outcomes were assessed using HHS preoperatively and at 3 and 6 months, along with operative parameters and postoperative complications. Statistical significance was set at p<0.05. Results: Among 40 patients, PFNA showed shorter operative time (78.5 vs. 92.3 min; p=0.003), lower blood loss (105.0 vs. 148.5 mL; p<0.001), and higher HHS at 3 and 6 months (78.4 vs. 72.6, p=0.04; 86.7 vs. 81.9, p=0.03) than DHS. Excellent/good outcomes were 85.0% vs. 70.0% (p=0.45), while complications were 15.0% vs. 30.0% (p=0.45), respectively. Conclusion: PFNA provided satisfactory functional outcomes with shorter operative time, lower blood loss, and higher follow-up Harris Hip Scores compared with DHS.