Abstract: Objective: To investigate the current status of prolonged length of stay (PLOS) in elderly hip fracture patients and analyze its affecting factors. Methods: A total of 1 444 elderly patients with surgical treatment for hip fractures were retrospectively analyzed.Patients were divided into two groups based on the length of stay.The PLOS group comprised 395 cases (hospital stay ≥15 d),while the normal group comprised 1 049 cases (hospital stay <15 d).Univariate analysis and multivariate regression analysis were used to study the factors influencing PLOS. Results: The incidence of PLOS was 27.35% (395/1 444).Univariate analysis showed that age,time from fracture to surgery,hypertension,coronary artery disease,hemiparesis,stroke,red blood cell volume distribution width,albumin,ASA classification,surgical method,duration of surgery,and postoperative pneumonia showed statistically significant differences between the two groups of patients (P<0.05 to P<0.01).Multiple regression analysis showed that longer time from fracture to surgery,hypertension,ASA ≥Ⅲ,long duration of surgery,and postoperative pneumonia were independent risk factors for PLOS in elderly hip fracture patients (P<0.05 to P<0.01). Conclusions: The incidence of PLOS is high in elderly hip fracture patients,and healthcare professionals need to identify factors affecting PLOS early and take early interventions to reduce the incidence of PLOS.