OBJECTIVE: To assess the association between alcohol drinking and hip fracture in the elderly people in Korea. BACKGROUND: Hip fracture is known as one of the major health problems because of its high incidence and serious consequences in the elderly people. The association between alcohol consumption and hip fractures has not been directly evaluated yet in Korea. So we conducted a nested case-control study to investigate the relationship between alcohol consumption and hip fracture in the Korean elderly people. DESIGN: Nested case-control study from the Korea Elderly Pharmacoepidemiology Cohort (KEPEC), in Pusan, Korea. METHODS: Seventy incident cases have been selected since 1993, and 280 controls have been matched with the cases by age and gender among the KEPEC. Average alcohol intake was calculated by multiplying frequency and amount of drinking and unit capacity of each alcohol type. Odds ratios of alcohol intake on the hip fracture and their confidence intervals were computed by using multiple logistic regression with Windows version SAS 6.12. RESULTS: The elderly people's drinking rate is lower than the young people in Korea. In univariate analysis, crude odds ratio was 0.26 in male and adjusted odds ratio after contolling for age, smoking status, medication history, physical activity and body mass index was 0.36 in male. So current drinking reduces the risk of hip fracture. Adjusted odds ratio after controlling for age, smoking status, medication history, physical activity and body mass index odds ratio was 0.24 in female with moderate drinking. CONCLUSION: We found that alcohol consumption reduces the risk of hip fracture in the elderly Korean. However, we could not explain the plausible mechanism with our data yet. So, we suggest the further study for elucidating the possible mechanism of the finding including the possible association between nutritional status, alcohol drinking and bone marrow density in the elderly.