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Background Efficacy of the use of hip geometry to predict femoral neck fracture is controversial and it is influenced by the particular race. Studies on the use of hip geometry in Aceh's population have never been done. Objectives To determine the association of hip geometry with femoral neck fracture in elderly women in Dr. Zainoel Abidin Teaching Hospital. Methods This study was an observational analysis. The design of this study was cross-sectional. The study was conducted in Dr. Zainoel Abidin Teaching Hospital from May to August 2013. Hip geometry measurements were done, such as the following: hip axis length (HAL), femoral neck axis length (FNAL), femoral neck angle (FNA), and neck width (NW). Statistical analysis used was logistic regression test. Results A total of 32 patients with femoral neck fractures and 32 control patients were followed in this study. The average value of hip geometry measurements in femoral neck fracture was HAL = 90.2 ± 8.6, FNAL = 77.2 ± 7.3, FNA = 131.7 ± 6.2, NW = 32.3 ± 3.4; and in nonfemoral neck fracture, it was HAL = 88.4 ± 9.4, FNAL = 76.2 ± 7.9, FNA = 131.5 ± 7.3, NW = 29.8 ± 3.3. Measurement HAL, FNAL, and FNA did not have a significant association with the incidence of femoral neck fracture ( P > 0.05). However, NW measurement had a significant association with the incidence of femoral neck fracture ( P < 0.05). Conclusion Only NW measurement had a significant association with femoral neck fracture in older women in Dr. Zainoel Abidin Teaching Hospital. [ABSTRACT FROM AUTHOR]