Subtrochanteric femur fractures are fractures that begin distal to the lesser trochanter and involve the proximal metaphyseal–diaphyseal region of the femur, posing considerable challenges in terms of reduction and stable fixation. The predominantly cortical structure of this region, its exposure to high mechanical stresses, and the deforming forces exerted by the surrounding muscles increase the risk of varus deformity, nonunion, and implant failure. Plain radiographs remain the primary imaging modality for diagnosis; however, advanced imaging, including computed tomography and, when indicated, magnetic resonance imaging, may be required in complex fracture patterns or when pathological or atypical fractures are suspected. The principal goals of contemporary treatment are to achieve anatomic or acceptable reduction, restore medial cortical support, obtain adequate mechanical stability, and facilitate early mobilization. Intramedullary nailing is currently the primary surgical treatment for most subtrochanteric femur fractures, whereas cerclage techniques, adjunctive plating, and locked plate fixation serve as complementary or alternative options in selected cases according to the fracture pattern and reduction requirements.