Hip fractures in the elderly are a major public health concern, associated with high rates of morbidity and mortality. This review synthesizes the extensive spectrum of complications following hip fracture surgery, categorizing them into medical, anesthetic, and surgical types. Medical complications are prevalent and multifactorial; cardiac events, including myocardial injury, are a leading cause of death, often predicted by elevated troponin and NT-proBNP levels. Postoperative delirium and cognitive dysfunction are common neurological complications, while venous thromboembolism remains a significant risk despite routine thromboprophylaxis. Other frequent issues include pulmonary infections, anemia, acute kidney injury, urinary tract infections, and pressure sores. Anesthetic complications, such as intraoperative hypotension and bone cement implantation syndrome, add to the perioperative risk. Surgically, complications vary by fracture type, ranging from fixation failure, non-union, and avascular necrosis in femoral neck fractures to implant cut-out and malunion in intertrochanteric and subtrochanteric fractures. Overall mortality remains high (14-36%), driven by non-modifiable and modifiable risk factors like advanced age, cardiac disease, and surgical delays. A comprehensive, multidisciplinary approach focusing on preoperative optimization, meticulous surgical technique, and proactive postoperative management is essential to mitigate these complications and improve patient outcomes.