32 adult patients undergoing femoral neck-cannulated screw fixation for femoral neck fractures were randomized to either laser-guided navigation (n=16) or a traditional freehand technique (n=16). Outcomes of interest included operative time, radiation time, total blood loss, pain on a Visual Analog Scale (VAS), Harris Hip Score (HHS), time to healing, and the incidence of success on the first attempt. Operative time, radiation exposure time, and total blood loss were significantly shorter in the laser group compared to the freehand group. The first success rate was also significantly higher in the laser group. VAS pain, HHS, and time to fracture healing were similar between the two groups. Implementing an innovative laser-guided navigation system for the placement of cannulated screws could greatly enhance surgical efficiency and offer more precision than manual techniques, potentially serving as a better and more effective substitute for traditional freehand techniques.