Objective To summarize and discuss the efficacy and perioperative treatment methods and experiences of patients with senior hip fractures. Methods One hundred and twenty-two cases of senior hip fractures, 41 males and 81 females, aged 75-96 years, with an average age of 82.5 years, were collected and treated surgically at our hospital from January 2000 to October 2006. The time from admission to surgery was 2-14 days. There were 54 cases of femoral neck fracture, 2 cases of Garden type I, 8 cases of type II, 35 cases of type III, and 9 cases of type IV; 68 cases of intertrochanteric fracture, including 7 cases of Evan type I, 24 cases of type II, 27 cases of type III, and 10 cases of type IV. The common preoperative comorbidities were coronary heart disease, diabetes mellitus, and hypertension. All patients were treated with different surgical approaches. Postoperative complications were mainly central nervous symptoms and pulmonary infection and urinary tract infection. Results All cases were safely treated through the perioperative period, with an average hospital stay of 20 days, and all kinds of surgical internal fixation and joint replacement were satisfactory on routine postoperative radiographic review. Postoperative symptoms such as mental disorders appeared 2-5 days after surgery, 9 cases recovered after symptomatic treatment, 2 cases improved; 7 cases of pulmonary infections were discharged after treatment, 6 cases were cured, 1 case was discharged after 1 week of postoperative symptoms improved and continued treatment in internal medicine; 1 case of upper gastrointestinal hemorrhage and 4 cases of urinary tract infection were cured after blood transfusion and symptomatic treatment; none of the cases in this group died, and no decubitus ulcer occurred. None of the cases in this group died, and no complications such as decubitus ulcer, symptomatic deep vein embolism and DIC occurred. Conclusion For elderly hip fracture patients, appropriate treatment plans should be formulated according to individual conditions, and the success rate of surgical treatment can be improved by actively controlling and preventing comorbidities and complications.