Background: The incidence of hip fractures expected to double in two decade and to triple by the 2050(Mj & Hhg 2008). Hip fractures can occur at any age, however previous studies shows that there is significant increase in the incidence of hip fracture with aging and most common in people aged 60 years and above due to increase in life expectancy and number of elderly people (Kim et al. 2010). The study done on prevalence and treatment of hip fractures in elderly patients seen at KCMC Orthopedic department from Jan-Dec 2015. Study broad objective: The broad objective of this study was to determine the prevalence and treatment of hip fractures in the elderly people admitted at KCMC orthopedic department from January to December 2015. Study population; 50 elderly patients with hip fractures seen at Orthopedic during study period. Study design; Cross-sectional retrospective hospital based study. Results; The prevalence of hip fractures in elderly people is 3.9%. Out of 50 elderly patients with hip fractures 28 (56.0%) were males, where by most patients falling under the age category between 60 – 80 years and mean age of 78 years. 45(90.0%) had fracture due to biomechanical factors mainly simple fall 30(60.0%) patients presented with pain on the affected hip joint and unable to walk as their clinical presentation and about 30(60.0%) had offered both conservative and surgical treatment modalities, 14(28%) had only conservative treatment modality and 6(12.0%) had only surgical treatment modality xi Conclusion: The prevalence of hip fractures in elderly people at KCMC is 3.9%, where by males are more affected compared to females. Most of the patients presented clinically with pain, unable to walk, shorten and external rotated limb. Most of the elderly patients with hip fractures are due to biomechanical risk factor. A large number of patients offered both conservative and surgical treatment modalities, few of them had either conservative only or surgical only. It is important to consider both modalities of treatment for the benefit of the patient that is to cut down the hospital stay, risk of fracture displacement and joint stiffness or arthritis.