Background <p>A multidisciplinary approach to older patients with hip fractures is increasingly recognized as a standard of care. This study aimed to analyze patients aged 75 years or older with hip fractures admitted to an Ortho-Geriatric Unit during a ten-year experience.</p> Methods <p>Observational prospective study, including all the patients admitted to the Ortho-Geriatric Unit from its inception in June 2013 until December 2022.</p> Results <p>A total of 748 hip fractures were admitted in the study. Median age was 85 years, with 555 females (74%) and 194 (26%) males. They came from their homes (84%) or nursing homes (16%). The most frequent fracture type was pertrochanteric (51%), followed by sub-capital (32%). Two hundred eighty-two patients performed ≥ 5 in the Pfeiffer test, 450 did &lt;5, and 237 did 0. The most frequent surgical technique used was intramedullary nailing in 453 cases (60%), followed by hemiarthroplasty (23%). The mortality rate during admission in the acute care hospital was 3%, and the 30-day mortality was 9.8%. The duration of admission in the Unit decreased from 35 days in 2014 to 21 days in 2022. Fifty-four patients (7.2%) were readmitted from the middle-term care facility. Geriatric syndrome rates decreased over time from 2017 to 2022.</p> Conclusions <p>The process of care described involves the orthopedic surgeon and geriatrician since admission, with timely surgical intervention, early mobilization, and transfer to a multidisciplinary functional recovery unit. This approach decreases the incidence of surgical complications, geriatric syndromes, and early and late mortality and improves functional outcomes.</p>