With the aging of society, fractures due to osteoporosis have increased significantly, especially hip fractures. Elderly hip fracture patients not only have fracture problems, but also have combined medical diseases such as hypertension, poor lung function, cardiac insufficiency, brain atrophy, liver and kidney insufficiency, diabetes, etc. Moreover, osteoporosis poses a greater challenge for orthopedic surgeons to choose the type of surgery and the fixation material that will allow the patient to get out of bed more safely, reduce bed-ridden complications, and restore the patient to near pre-injury mobility. Whether to treat conservatively or surgically, many patients’ families and patients think that patients are old and poor, and surgical treatment is risky and refuse to treat surgically, but according to the literature, the mortality rate of conservative treatment is higher than that of surgical treatment. Conservative treatment of hip fracture includes bed rest, skin traction, bone traction for 8-12 weeks, too long bed rest, easily complicated by deep vein thrombosis, lung infection, decubitus ulcer, urinary tract infection, muscle atrophy, osteoporosis, deformed healing of the fracture, and return to pre-injury mobility are not possible. As long as there are no absolute contraindications to surgery and anesthesia, preoperative evaluation is perfected, and with the assistance of an internist, patients can undergo functional training and get out of bed without pain after surgical treatment, which can significantly reduce bedridden complications, restore pre-injury mobility, and improve quality of life and longevity. For hip fractures in the elderly, I suggest that if there is no absolute contraindication to surgery, surgical treatment is the first choice.