Objective  To investigate the optimal screw configuration for internal fixation of femoral neck fractures based on anatomic analysis on radiologic imaging.   Methods  From January to February 2017, thirty proximal femurs of 15 normal adults from Picture Archiving and Communication Systems（PACS） of Paople’s Hospibal of Anji were constructed by CT. 8 males and 7 females with a mean age of (43±8.5) years (ranging from 28 to 63 years).The medial femoral neck sections (FNS) were projected on the lateral femoral trochanteric wall. The simulated three screw configurations in the projection of FNS include: two inverted equilateral triangles symmetrized to the axis of the FNS (IET-FNS group) or the coronal axis of the proximal femur (IET-PF group) and an obtuse triangle (OT group).The distance between the screws, the distance between the centre of the FNS and the screws, and the area ratio of the triangle/FNS were calculated.   Results  The projection of the FNS on the lateral femoral trochanteric wall was displayed as a rotating forward ellipse. Measurements of distance between screws：OT group（5.96±0.37）cm；IET-FNS group（4.74±0.39）cm；IET-PF group（4.58±0.39）cm. Distance between the centre of the FNS to the screws：OT group（3.43±0.18）cm；IET-FNS group（2.81±0.17）cm；IET-PF group（2.72±0.14）cm. And the area ratio of triangle/FNS OT group（0.31±0.01）；IET-FNS group（0.21±0.02）；IET-PF group（0.16±0.01） were significant larger in the OT group than in the IET-FNS and IET-PF groups (P<0.05). The values of the three parameters in the IET-FNS group were also larger than those in the IET-PF group (P<0.05).   Conclusion The obtuse triangle screw configuration displays advantages with respect to the parameters of distance between screws, distance between the centre of FNS to screws, and the triangle area. Therefore, the obtuse triangle screw configuration may be the ideal pattern for internal fixation of femoral neck fractures. This needs to be corroborated with biomechanics testing.