Hip fracture is a common, devastating, and often fatal trauma in older people. In Finland, the incidence of hip fractures increased steadily until the late 1990’s. Thereafter signs of declining incidence trend have been observed. Currently, the annual number of hip fractures is over 7000. The hip fracture patients are predominantly women (70%) aged 80years and over, and most (76%) are community-dwelling. All patients with a hip fracture are referred to hospital for surgical assessment, and nearly all are operated on. One third of the hip fracture patients aged 70 and over die during the first post fracture year. Hip fractures have also negative long-term effects on morbidity and hospitalizations. Substantial mortality, utilization of inpatient care and rate of institutionalization following hip fractures poses the question: could we do better? Adherence with the up-to-date and evidence-based national practice guideline for treating hip fracture patients is suboptimal. There is room for improvement in the perioperative management, postoperative care and rehabilitation of these patients.