This meta-analysis examines the excess mortality risk after hip fracture in older adults, specifically focusing on the duration and magnitude of this risk. The study included 22 cohorts of women and 17 cohorts of men aged 50 years or older, with hip fractures, and compared them to age- and sex-matched control groups. The analysis found that the relative hazard (RH) for all-cause mortality in the first 3 months after hip fracture was significantly higher in women (5.75, 95% CI 4.94 to 6.67) and men (7.95, 95% CI 6.13 to 10.30). This excess mortality decreased over time but did not return to the levels seen in the control groups even after 10 years. The excess annual mortality was higher in men than in women at any given age, with white women experiencing an excess annual mortality of 8%, 11%, 18%, and 22% at 1, 2, 5, and 10 years after injury, respectively, and white men experiencing an excess annual mortality of 18%, 22%, 26%, and 20% at the same time points. The study highlights the significant long-term impact of hip fractures on mortality and suggests that these risks are higher in men than in women.This meta-analysis examines the excess mortality risk after hip fracture in older adults, specifically focusing on the duration and magnitude of this risk. The study included 22 cohorts of women and 17 cohorts of men aged 50 years or older, with hip fractures, and compared them to age- and sex-matched control groups. The analysis found that the relative hazard (RH) for all-cause mortality in the first 3 months after hip fracture was significantly higher in women (5.75, 95% CI 4.94 to 6.67) and men (7.95, 95% CI 6.13 to 10.30). This excess mortality decreased over time but did not return to the levels seen in the control groups even after 10 years. The excess annual mortality was higher in men than in women at any given age, with white women experiencing an excess annual mortality of 8%, 11%, 18%, and 22% at 1, 2, 5, and 10 years after injury, respectively, and white men experiencing an excess annual mortality of 18%, 22%, 26%, and 20% at the same time points. The study highlights the significant long-term impact of hip fractures on mortality and suggests that these risks are higher in men than in women.