Objective Compare the epidemiological differences of hip fracture patients in Spain and China. Materials and Method This was a retrospective study. The study population came from patients with hip fractures who underwent surgery between January 1, 2017 and December 30, 2017 at the University Hospital Virgen Macarena (UHVM) in Seville, Spain and Xi’an Daxing Hospital (XDH) in Shaanxi Province, China. Through medical history review and telephone follow-up, the differences of demographic and anthropometric characteristics, lifestyle, personal medical history, variables related to injury, anesthesia, and surgery, length of stay in hospital, days of bed rest, and mortality of patients in the two hospitals were compared. Results A total of 757 patients were enrolled, of which 426 were from UHVM and 331 were from XDH. The average age was 81.4±9.26 years and 76.0±8.08 years, respectively; the male and female distribution was 25.1% and 74.9% vs. 32.0% and 68.0%. The average BMI of Spanish patients was higher than that of Chinese patients. The proportion of drinking and smoking among Spanish patients was significantly higher than that of Chinese patients (p = 0.000, p = 0.000, respectively). The proportion of patients with ≥ 3 comorbidities in Spain was higher than that in China (p = 0.002). The surgery delay time of Spanish patients was significantly longer than that of Chinese patients (p = 0.000). Spanish patients had a shorter hospital stay, but a longer time in bed. During the one-year follow-up, there were 81 deaths in Spain and 43 deaths in China (p = 0.026). Conclusiones There are large epidemiological differences between hip fracture patients in Seville, Spain and Xi'an, China in terms of demographics, lifestyle, comorbidities, surgical methods, and mortality.