This is the first prospective study to estimate the incidence of hip fractures in the general population in Lebanon. All orthopaedic surgeons in Beirut reported on hip fracture cases between 1 October and 31 December 1996. Data were extrapolated to 1 year and standardized for the whole population. The estimated annual incidence rate was 0.129% (women: 0.153%, men: 0.100%), increasing with age and remaining higher in women. Our figures are comparable with larger studies in other Mediterranean countries. The incidence rate of hip fractures in our population falls within a gradient of risk between the west and the east and the north and the south, highlighting the importance of environmental and genetic factors as risk factors for osteoporotic fractures.