Abstract: Objective To explore the clinical effect of operation within 48 hours and after 48 hours of fracture in the elderly patients with hip fractures. Methods A total of 94 elderly patients with hip fractures who were confirmed and accepted surgical treatment in our hospital were selected as study objects, and were divided into early group(n=40)and delayed group(n=54)according to different timing of operation. The early group was given operation within 48 hours after fracture, while the delayed group was given operation after 48 hours of fracture. Basic operation indexes, hospitalization time, complication rate, fracture healing conditions and Harris score of hip joint function were compared between the two groups. Results There were no significant differences between the two groups in operation time and bleeding volume(P>0.05); the hospitalization time and fracture healing time in the early group were significantly shorter than those in the delayed group(P<0.05); the incidence rates of complications such as incision infection, pulmonary infection, deep vein thrombosis(DVT)of lower extremities and delirium showed no significant differences between the two groups(P>0.05), but the total complication rate of the early group was significantly lower than that of the late group(12.50% versus. 31.48%, P< 0.05); six months after operation, the excellent and good rate of Harris score of hip joint in the early group was slightly higher than that of the delayed group, but there was no significant difference between the two groups(87.50% versus. 77.78%, P>0.05). Conclusion The elderly patients with hip fracture should receive surgeries within 48 hours after fracture, which is helpful to shorten the hospitalization time and fracture healing time, and reduce occurrence of complications.