Hip fractures in patients with Parkinson's syndrome present a continuing challenge to orthopaedic surgeons. Sixty-two consecutive such patients have been reviewed. With or without operation, there was very high rate of mortality (31%) and complications. However, the functional results, the ability to walk, progression of the disability, and the quality of life were significantly better after operation. The results suggest that operation is the preferable solution for these patients. They require, however, much more particular care than other patients with hip fractures. This includes adequate adjusted antiparkinson medication, appropriate anesthesia with special attention to adequate ventilation and postoperative analgesia, more intensive respiratory and functional physiotherapy, very meticulous nursing care, and a relatively extended period of preventive antibiotics.