This systematic review examines the country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture worldwide. The study identified 72 studies from 63 countries and 45 FRAX models from 40 countries. Age-standardized rates of hip fracture varied more than 10-fold between countries, with the lowest rates in Nigeria, South Africa, and Ecuador, and the highest in Denmark, Norway, Sweden, and Austria. The 10-year probability of a major osteoporotic fracture also showed a similar range, with the lowest probabilities in Tunisia, Ecuador, the Philippines, and China, and the highest in Denmark, Sweden, Norway, and Switzerland. The findings highlight significant variations in hip fracture risk and fracture probability globally, which cannot be fully explained by errors in case ascertainment or catchment populations. Understanding these heterogeneities may inform global strategies for fracture prevention.This systematic review examines the country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture worldwide. The study identified 72 studies from 63 countries and 45 FRAX models from 40 countries. Age-standardized rates of hip fracture varied more than 10-fold between countries, with the lowest rates in Nigeria, South Africa, and Ecuador, and the highest in Denmark, Norway, Sweden, and Austria. The 10-year probability of a major osteoporotic fracture also showed a similar range, with the lowest probabilities in Tunisia, Ecuador, the Philippines, and China, and the highest in Denmark, Sweden, Norway, and Switzerland. The findings highlight significant variations in hip fracture risk and fracture probability globally, which cannot be fully explained by errors in case ascertainment or catchment populations. Understanding these heterogeneities may inform global strategies for fracture prevention.