A systematic review of hip fracture incidence and probability of fracture worldwide was conducted to assess global variations in hip fracture risk and major osteoporotic fracture probability. The study analyzed data from 63 countries and 45 FRAX models available in 40 countries. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries. Hip fracture rates varied significantly, with the highest rates observed in Denmark, Norway, Sweden, and Austria, while the lowest were found in Nigeria, South Africa, and Tunisia. For women, the highest rates were in Denmark, Sweden, and Norway, while the lowest were in Nigeria and South Africa. The 10-year probability of a major osteoporotic fracture was also highly variable, with the highest probabilities in Denmark, Sweden, and Norway, and the lowest in China, Philippines, and Tunisia. The study highlights the significant differences in hip fracture risk and fracture probability worldwide, which cannot be explained by errors in case ascertainment or catchment population. Understanding these variations may lead to global strategies for fracture prevention. The findings emphasize the need for further research to identify the underlying reasons for these differences and to develop targeted interventions. The study also notes that while probability estimates were lower in men than in women, the difference was modest compared to the twofold difference in hip fracture risk. The study concludes that there are significant variations in hip fracture risk and fracture probability worldwide, which have important implications for public health and prevention strategies.A systematic review of hip fracture incidence and probability of fracture worldwide was conducted to assess global variations in hip fracture risk and major osteoporotic fracture probability. The study analyzed data from 63 countries and 45 FRAX models available in 40 countries. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries. Hip fracture rates varied significantly, with the highest rates observed in Denmark, Norway, Sweden, and Austria, while the lowest were found in Nigeria, South Africa, and Tunisia. For women, the highest rates were in Denmark, Sweden, and Norway, while the lowest were in Nigeria and South Africa. The 10-year probability of a major osteoporotic fracture was also highly variable, with the highest probabilities in Denmark, Sweden, and Norway, and the lowest in China, Philippines, and Tunisia. The study highlights the significant differences in hip fracture risk and fracture probability worldwide, which cannot be explained by errors in case ascertainment or catchment population. Understanding these variations may lead to global strategies for fracture prevention. The findings emphasize the need for further research to identify the underlying reasons for these differences and to develop targeted interventions. The study also notes that while probability estimates were lower in men than in women, the difference was modest compared to the twofold difference in hip fracture risk. The study concludes that there are significant variations in hip fracture risk and fracture probability worldwide, which have important implications for public health and prevention strategies.