Objective To compare the analgesic effects of ultrasound‑guided hip joint injection (HI) and fascia iliaca compartment block (FICB) of ropivacaine in preoperative analgesia of elderly patients hip fractures, so as to provide basis for optimizing preoperative analgesia of hip fractures. Methods Sixty elderly patients with intracapsular hip fractures undergoing unilateral hip arthroplasty, regardless of gender, aged 65−80 years, ASA grade Ⅱ−Ⅲ, BMI 18−25 kg/m2, were divided into experimental group (HI group) and control group (FICB group) by random number table method, with 30 cases in each group. HI group: ultrasound parallels the femoral neck,identifies the iliofemoral ligament, and injects the ropivacaine between the joint cavity and the trochanter capsule. FICB group: using ultrasound to identify the "hillside sign", transversus abdominal muscle, iliac muscle and lilac fascia, and injects the ropivacaine under the iliac fascia. The following data of patients were recorded: general conditions. Resting and motor Visual Analogue Scale(VAS) scores before regional anesthesia (T0), 20 min after regional anesthesia (T1), 12 h after regional anesthesia (T2), 24 h after regional anesthesia (T3), 48 h after regional anesthesia (T4). Passive hip flexion angle from T1 to T4 and the occurrence of complication in the two groups. Results The general conditions between the patients in two groups did not show significant difference (P>0.05). The VAS scores of resting and motor in HI group from T1 to T4 were lower than T0 (All P<0.05). The VAS scores of resting and motor in FICB group from T1 to T4 were lower than T0 (All P<0.05). Compared with FICB group, the motor VAS score of T1−T4 in HI group decreased (All P<0.05), T1−T4 passive hip flexion angle was increased (All P<0.05). There was no significant difference in complication between the two groups (P>0.05). Conclusions The analgesic effect of HI is better than FICB in patients with hip joint intracapsular fracture, and it