Hip fracture, the most dramatic complication of osteoporosis, constitutes a serious health problem of the elderly, with great socioeconomic consequences. Hip fracture epidemiology has been studied by many investigators. Until now, there are no reported studies in Iran regarding this issue. We studied hip fractures that occurred in Iran in 2003 and compared the findings with those of other countries. Data used were obtained from the Iranian Multicenter Study on Accidental Injuries, a large-scale population-based study conducted in 9 provinces across the country. The study was conducted by the Ministry of Health and Medical Education and continued for 135 days (4.5 months) in all centers, beginning in a date between 15 June 2003 and 15 July 2003 for each center. A total of 1482 new cases of hip fracture (1079 male, 403 female) were recorded during the study period. The crude annual incidence of hip fracture (per 100000 person-years) was 59.8 in men and 23.5 in women. The incidence rates increased exponentially after the age of 60 in both genders and nearly tripled after each decade. In comparison with hip fracture incidence rates of other countries, Iranian rates are considerably lower than other Asian, European, and American countries. The reasons for this low incidence rate remain uncertain. With increase in life span, rapid economic development and aging of the population, hip fracture will become a major health problem in Iran and studies are needed to increase awareness of osteoporosis and to monitor the epidemiology of hip fractures.