Hip fracture is one of the major causes of death and injuries of the elderly, and its occurrence rate is increasing with the progress of aging population, which becomes a heavy economic burden on the family and society. The main treatment for proximal femoral fractures includes fracture fixation and hip arthroplasty. This review is focused on the relationship between anatomical structure and load transfer mechanism of the proximal femur, mechanical distributions on cortical and cancellous bone in the proximal femur, and the latest progress in biomechanical research on risk prediction of hip fracture both in China and abroad, which will contribute to understand hip fracture from a biomechanical perspective, improve the accuracy of risk prediction of hip fracture in the elderly, as well as treatment of hip fracture, the correct selection and application of othopaedic implants.