Purpose Management of fracture nonunion is challenging as another surgical intervention for the patient is often a necessity, which has a huge impact on both quality of life and economic burden of the patient. Thus, a less aggressive and better accepted treatment for nonunion is required. Methods We gave teriparatide to a 45-year-old man with femoral fracture nonunion 1 year after he underwent surgery with autogenous bone grafting that failed to heal his initial nonunion. Successful union was obtained after once-daily administration of teriparatide for 9 months. Results Our case showed teriparatide could successfully treat a femoral fracture nonunion that autogenous bone grafting failed to heal. Conclusions Teriparatide may provide an alternative treatment for fracture nonunion.