Objective To investigate the perioperative mortality risks of elderly patients with hip fracture.Methods A retrospective review was made on 177 elder patients with hip fracture hospitalized from January 2012 to January 2014.There were 79 males and 98 females,aged from 61 to 92 years (mean,72.2 years).Intertrochanteric or femoral neck fracture was noted in 109 patients and 68 patients respectively.Sixty patients were complicated with two or more medical conditions,97 were complicated with one medical condition,and 20 had no other complications.In all,177 patients were treated surgically,including closed or minimally invasive limited open reduction and internal fixation (n =107),open reduction and internal fixation (n =48),total hip replacement (n =17) and half hip replacement (n =5).Correlations of perioperative death with age,fracture type,anesthesia,operation mode and preoperative complications were determined.Results Seven patients died within perioperative period.Six deaths aged more than 80.Six deaths were complicated with 2 medical conditions and over.Mortality rate was 7.14％ among the conventionally operated patients and 1.87％ among the patients operated in a minimally invasive way.Perioperative mortality was 33.33％ among the patients operated for ＞ 120 min and 3.45％ among the patients operated for ≤ 120 min.Conclusions A higher mortality occurred in the patients aged ＞ 80 years and with more than two medical conditions,especially pulmonary.disease.Perioperative mortality relates to operative ways and operative time,and seems to have a strong relationship with minimally invasive operation and operation time ＞ 120 min.