Fifty-six fractures of the proximal femur in 53 stroke survivors are described in this retrospective review. The side of fracture was found to be positively correlated with the side of hemiparesis (P less than 0.001). In all cases, the immediate proximate cause of the hip fracture was described as a fall. Falls most frequently occurred in the bathroom or during transfer activities. Though this group was largely ambulatory and living at home prior to fracture, only a minority of individuals were either ambulatory (40%) or able to return home (39%) immediately after discharge.