OBJECTIVE: To retrospectively analyze the characteristics, complications and mortality factors of perioperative period in elderly hip fracture patients and to discuss the combined Chinese and Western risk management in the perioperative period of elderly hip fracture. METHODS: We collected hip fracture patients aged >65 years who underwent surgical treatment, including patients with femoral neck fracture and intertrochanteric fracture, treated with internal fixation or hip replacement surgery, and combined Chinese and Western perioperative management, and counted their preoperative coexisting conditions, postoperative complications and mortality factors. Results: 82.9% of elderly hip fracture patients chose surgery, 81.4% of patients had preoperative coexisting conditions, 32.03% of patients had postoperative complications, and the overall in-hospital mortality rate was 1.5. Conclusion: Elderly hip fracture patients have many preoperative coexisting conditions and high surgical risks, so adequate preoperative evaluation, good perioperative management of various coexisting conditions and psychological status, and appropriate use of Chinese medicine methods to intervene in the whole treatment process. The risk of perioperative hip fracture in elderly patients can be effectively managed by adequate preoperative assessment, good control of various coexisting conditions and psychological status during the perioperative period, appropriate intervention of Chinese medicine in the whole treatment process, surgical methods such as internal fixation surgery or hip arthroplasty, postoperative infection control, regulation of water and salt balance, prevention and control of complications such as stress ulcers, embolism and delirium, appropriate analgesic measures, comprehensive specialized care and reasonable and standardized rehabilitation process. With the update and improvement of ICU equipment and comprehensive technology, the level of control of preoperative coexisting diseases and postoperative complications of elderly patients will be improved accordingly.