[Objective] To investigate the influencing factors for postoperative mortality in elderly hip fracture patients. [Methods] To retrospectively analyze the medical record and follow-up data of 177 elderly hip fracture patients surgically treated in our hospital from January 2017 to January 2019, and record data on age, gender, clinical tests, ADL (activities of daily living, ADL) score and survival data. The patients were divided into survival and death groups, and the indicators of the two groups were analyzed univariately, and Cox survival analysis was performed on the follow-up data. [Results] Of the 177 patients, 109 were alive at 2 years postoperatively, with a survival rate of 74.15%.Univariate analysis showed that patients in the death group were older, had a higher number of comorbid underlying diseases, a lower proportion of family chaperones, a worse preoperative ADL score, and a lower preoperative hemoglobin and albumin amount compared with the survival group, with statistically significant differences (P<0.05). Cox survival analysis showed that family chaperones (OR=0.382, P=0.008), preoperative ADL score (OR=0.982, P=0.023), preoperative hemoglobin amount (OR=0.978, P=0.004) and preoperative albumin amount (OR=0.845, P<0.001) were protective factors for postoperative mortality in elderly hip fractures, while the number of preoperative underlying diseases (OR=3.926, P=0.002) was a risk Factors. [Conclusion] Family companionship, high preoperative ADL scores, and high preoperative hemoglobin and albumin levels were protective factors for death after hip fracture in the elderly; whereas a high number of underlying diseases was a risk factor for death after hip fracture in the elderly.