Objective To apply finite element method for analyzing the biomechanics status and stability of internal fixation for Vancouver type B1 periprosthetic femoral fractures. Methods CT image data of the left femur from 30 healthy middle-aged or elderly volunteers and the profile data of femur prosthesis and locking compression plate were collected and used for 3D reconstruction. Three different types of internal fixation Methods for Vancouver type B1 periprosthetic femoral fracture were simulated. The proximal part of the prosthesis was fixed with cable cerclage, single-cortical locking screw and a combination of both, and the load simulating full load or partial load was applied. Then the maximum displacement and Von Mises stress were observed. Results There was no significant difference in the maximum displacement or Von Mises stress between cable cerclage fixation and single-cortical locking screw fixation under full and partial loads. The maximum displacement and Von Mises stress were decreased and the internal fixation was more stable when the two fixations combined together, with significant difference found between cable cerclage fixation and single-cortical locking screw fixation (P<0.05, P<0.01). Conclusion Combination of cable cerclage and single-cortical locking screw is the first choice for internal fixation in the treatment of Vancouver type B1 periprosthetic femoral fracture.