Aims: Hip fracture is frequently studied to reflect osteoporosis related fractures. The aim of this study was to look at ethnic differences in the incidence of hip fractures between the three races in Malaysia. Methods: This was a retrospective study performed for the years 1996 and 1997. Data from hospitals treating hip fractures in elderly patients were collected throughout the whole country. Result: The overall incidence of hip fractures was 90 per 100 000 individuals. Sixty-three percent of patients presenting with hip fractures were Chinese. This was followed by Malays at 20% and Indians, 13%. Race-specific incidence data showed that the fracture rates are highest among the Chinese (160 per 100 000) followed by Indians (150 per 100 000) and Malays (30 per 100 000). Females were twice as commonly affected compared to males. Race and sex-specific incidence data showed that the incidence was highest among Chinese females (220 per 100 000), followed by Indian females (200 per 100 000). The age-specific incidence was 500 per 100 000 for patients above 75 years, compared to 10 per 100 000 in those between 50 and 54 years. Conclusion: Hip fractures arecommon in Malaysia. There are differences in hip fracture incidence depending upon ethnicity. © 2007 Asia Pacific League of Associations for Rheumatology.