Hip fractures in elderly people are an important public health problem. The incidence varies with ethnic group and shows wide geographical variation. To examine the effect of body mass index, dietary calcium intake, fertile period, physical activity, and years of education on the risk of hip fracture, a case-control study was undertaken, as part of the MEDOS study, involving 519 women with hip fracture and 808 controls aged 50 or more years from Spain and Turkey. The results of this study suggest that low body mass index, low dietary calcium intake, low physical activity, a short fertile period, and a short period of education are associated with increased risk of hip fracture. The findings confirm previous reports of the influence of several potential risk factors for hip fracture and demonstrate for the first time a protective effect of education.