Proximal femoral fractures are common in the elderly population and are associated with significant morbidity, mortality, and major functional consequences. Their management represents an ongoing challenge. Care for this frail population must be coordinated, standardized, and multidisciplinary. These fractures represent a significant public health concern, prompting numerous studies to explore organizational strategies and risk factors aimed at minimizing related complications. This article reviews current recommendations for the management of proximal femoral fractures in the elderly, including definitions of geriatric and frail patients, service organizations, and clinical pathways. It also provides an overview of the latest recommendations for the management of medical problems and anticoagulation in elderly patients with proximal femur fractures.