Objective The purpose of this study was to investigate the incidence of deep vein thrombosis (DVT) in elderly patients with hip fractures before surgery. Methods This retrospective study included 276 elderly patients with hip fracture hospitalized from January 2017 to December 2020. There were 94 males and 182 females with an average age of 77.4 years. There were 178 cases of intertrochanteric fracture and 98 cases of femoral neck fracture. All patients underwent ultrasound to screen for DVT, and 44 patients also underwent lower extremity CT venography.Patients with DVT were given Inferior Vena Cava Filter (IVCF) before surgery. Results None of the patients had signs or symptoms of DVT before surgery. DVT was detected in 38 patients, with a total incidence of 13.8% (38/276). The average time to the emergency room after injury was 31.4 hours. The mean time from hospitalization to surgery was 24.9 hours. The mean time from injury to hospitalization for patients with DVT was 234h, significantly higher than that for patients without DVT (27.4h, P<0.001). Among the patients admitted within 72h, the incidence of DVT was 11.3% (28/248), and among the 28 patients admitted after 72h, DVT occurred in 10 patients (35.7%), with significant statistical difference (P<0.001). Conclusion The preoperative incidence of DVT in elderly patients with hip fracture is relatively low (13.8%), but emphasis on DVT should be considered when admission or surgical delay with greater than 72 hours.