62 elderly patients with acute complex proximal humeral fracture were randomized to either undergo reverse shoulder arthroplasty (RSA) or hemiarthroplasty. This study aimed to compare the short-term outcomes of both operative fixation methods in terms of pain and function. Results revealed that the RSA group had significantly better mean University of California Los Angeles (UCLA) score, Constant score, and range of forward elevation and abduction than the HA group. It was noted that HA patients had a significantly higher Disabilities of the Arm, Shoulder, and Hand score and six HA patients had proximal migration and needed revision to RSA. Furthermore, complications reported in both groups were comparable. Further long-term evaluations are needed to compare these two treatment methods.