Seventy patients with were randomized to 3D-printed navigation template–assisted proximal femoral nail antirotation (PFNA) (n=35) or conventional PFNA (n=35). The primary outcome was operative time. Secondary outcomes included C-arm fluoroscopy frequency, intraoperative blood loss, main-incision length, Harris Hip Score (HHS) and pain (VAS) at 1, 3, and 12 months, and adverse events. Follow-up occurred to 12 months. Overall, the results showed shorter operations, fewer fluoroscopy shots, less blood loss, and smaller incisions with the template; HHS was higher and VAS lower at all postoperative timepoints, with no adverse events in either group. These findings suggest patient-specific guides can streamline PFNA and enhance recovery without added complications.