This retrospective study was undertaken to evaluate the mortality and morbidity of patients undergoing hip fracture surgery within 12 h of admission, compared with surgery more than 12 h after admission, the patients had no acute medical conditions that required preoperative treatment. Mortality rates were based on survival of the patients up to 1 year after surgery. For patients with fractures of the femoral neck, and in whom surgery was performed within 12 hours of admission, the mortality rate was significantly lower from 5 months after the operation. Time of surgery did not influence the mortality of patients with trochanteric fractures. It is suggested that a fractured neck of the femur in an otherwise fit elderly patient should be regarded as a surgical emergency.