Abstract: Objective To compare the diagnostic reliability of intertochanteric fracture AO and Evans-Jensen classifications in X ray film and three-dimensional CT reconstruction images and explore advantage of the three-dimensional CT. Methods A retrospective study was performed to evaluate 54 intertochanteric fractures．Thress orthopaedic surgeonswere asked to make assessment of fracture classifications using X ray film and the three-dimensional CT images. Agreement test was performed to evaluate interobserver and intraobserver reliability for fracture classification. Results When X ray film was used, interobserver reliability mean kappa value between three surgeons for AO and Evans-Jensen classifications were 0.597 (0.547-0.653) and 0.571 (0.539-0.600), medium consistency. While using three-dimensional CT to AO classification lower kappa value was 0.411 (0.366-0.455), medium consistency, Evans - Jensen classification kappa value was 0.704 (0.671-0.737), highly consistency. Each surgeon respectively through the X ray film and three-dimensional CT the AO and Evans-Jensen classification mean kappa value were 0.464 (0.406-0.579), medium consistency and 0.191 (0.160-0.233), weak consistency. Conclusion Both classifications based on X ray film showed moderate consistency , using three-dimensional CT does not improve the consistency of AO classification. And the three-dimensional CT does not apply to Evans-Jensen classification.