Length of stay (LOS) is an important determinant of hospital performance. Proximal femur fractures are an important cause of morbidity in the elderly and comprise a significant proportion of acute orthopedic admissions. This study focuses on the underlying factors which may affect hospital length of stay of patients with fracture femur in Kasr El-Aini hospitalThe aim of this study is to improve the efficiency of hospital care for patients suffering from femur fractures. The study was divided into three parts:FRF admitted to Kasr El Aini hospital day during the period Records of : Review of Records-Afrom 1st of January 2005 to 31 December 2007 (3996 patients) were retrieved.erview performed with System analysis was conducted through in depth int: System Analysis-Bthe physicians and nurses.All . This part was conducted in two orthopedic departments:The Prospective Study -Cadmitted cases with femur related fracture cases within the study duration were included.The results of this research were:There are no written protocols. However all of the interviewed nurses and doctors agreed that there are implicit protocols in dealing with the patients.Recorded data revealed that the mean length of stay of FRF cases was12.8±14.9 days. In the three years the shortest hospital stay was that of patients < one year old, while patients belonging to age group 40- 64 had the longest length of stay. There was a statistically significant difference between the different age groups in each year. While there was insignificant difference between both males and females as regards their mean length of stay. There were significant differences between different orthopedic departments as regards the LOS of FRF cases in the three years. While there were insignificant differences between different types of FRF cases.About 37.4 % of those who were in need for operation both department had it around 9th to 15th day. About 62% of the patients with different types of FRF had longer hospital stays than that was planned for each of them. The pre-operative causes of delay represented about 78% of total cases, patients factors had the main bulk constituted 62% of them, doctor's factors 29% and about 7.8 of FRF patients delayed due to financial causes. The post- operative causes presented 21.9% of the total causes of delay. By logistic regression both the patients' age and type of fracture affected the LOS of the recorded FRF patients, while LOS of follow up patients was significantly affected by patients' age, echocardiography timing and operation timing. It is recommended to put guidelines and protocols for scheduled care of FRF cases and proper documenting of each event that happens during patient follow up.