The problem of hip fracture in the elderly is becoming more and more serious. These patients also present one or more basic diseases, which greatly increase the risk of operation. Currently, there is no uniform standard to analyze the outcome and prognosis of elderly patients with hip fractures. This article reviews the postoperative risk assessment system for elderly patients with hip fracture, and discuss the application of the American Society of Anesthesiologists (ASA) classification, the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) score and modified POSSUM score system, Nottingham Hip Fracture Score (NHFS), Daping Orthopedics Operative Risk Scoring System for Senile Patient (DORSSSP) in the evaluation of hip fracture in elderly patients. Each of the above methods is effective in predicting postoperative risk to various extents, with different advantages. The DORSSSP system is more suitable for Chinese patients than other scoring systems, but it still needs to be verified in further studies.