Objective To analyze the impact of surgical timing on postoperative complications and quality of life in elderly patients with hip fractures. Methods A prospective trial was conducted on 152 elderly patients undergoing fractured hip surgery in our department from April 2020 to April 2023. According to their surgical timing, they were divided into early surgery group (from fracture to surgery <48 h, n=84) and delayed surgery group (≥48 h, n=68). The perioperative parameters, hip function recovery, postoperative complications and quality of life were compared between two groups. SPSS statistics 20.0 was used for data analysis. Depending on data type, student′s t test orChi-square test were applied for comparison between groups. Results Significantly less intraoperative blood loss, shorter length of hospital stay and fracture healing time, lower visual analogue scale score at 24 h and 3 months postoperatively, and reduced incidence rates of postoperative deep venous thrombosis and urinary tract infection, and higher Harris score, and increased excellent and good rate of hip function recovery at 6 months after surgery were observed in the early surgery group than the delayed surgery group (all P<0.05). The World Health Organization quality of life-BREF scores of physiology, psychology, social relations and environment were elevated in both groups than before surgery (P<0.05), and the scores in early surgery group were obviously higher than those in the other group (P<0.05). Conclusion For the elderly patients with hip fracture, early surgery (within 48 h after fracture) can shorten the hospital stay and fracture healing time, reduce the postoperative pain, and lower the risk of deep venous thrombosis and urinary tract infection, and thus, result in better postoperative hip function and quality of life.