[Objective] To explore the risk factors of deep vein thrombosis (DVT) in the perioperative period of hip fractures in the el- derly, and to establish a prediction model to guide clinical prediction of DVT. [Methods] A retrospective study was conducted on 384 elder- ly patients who received surgical treatment for hip fractures in our hospital from August 2015 to September 2021. According to the occur- rence of thrombosis, the patients were divided into DVT group and non-DVT group. Univariate and multivariate analysis were performed to identify the risk factors of DVT in lower extremities, and establish the prediction model and evaluate the efficiency of the model. [Results] Among 384 patients, 67 cases (17.5%) developed lower extremity DVT in the perioperative period. In term of univariate comparison, there were no significant differences in terms of age, sex, fracture type, fracture side, ASA grade, time elapsed between the injury and surgery, whether oral anticoagulant, antithrombotic drugs, underlying medical disease, surgical procedure and anesthesia, as well as Hb, HCT, WBC, PLT, fibrinogen, D-dimer, PT and PO2 measured on admission between the two groups (P＞0.05) . However, the DVT group had sig- nificantly longer waiting time before surgery, ≥3 types of comorbidities, higher proportion of blood transfusion and combined fractures, lon- ger operation time, more intraoperative blood loss, and longer APTT than the non-DVT group (P＜0.05) . As results of multivariate binary lo- gistic regression analysis, perioperative blood transfusion (OR=2.565, P＜0.001) , number of comorbidities ≥3 (OR=1.880, P=0.031) , longer preoperative waiting time (OR=1.110, P＜0.001) were the independent risk factors for perioperative DVT of lower extremity. The accuracy of lower extremity DVT prediction equation based on logistic regression results was of 82.8%, with the critical cutoff value of 0.319, the sensi- tivity of 71.6%, the specificity of 60.3%, and the area under the ROC curve of 0.705. [Conclusion] Longer preoperative waiting time, peri- operative blood transfusion and ≥3 kinds of underling medical diseases are the independent risk factors for perioperative DVT of lower ex- tremities. In addition, this DVT prediction model is helpful to judge the risk of thrombosis and prevent it in advance.