Hip fractures are a major cause of burden associated with osteoporosis in terms of mortality, disability, and costs. Many studies reveal an increase of the age-adjusted hip fracture incidence but long-term data on secular changes in women and men within a well-defined community are still rare. From 1991 to 2000, 4115 hip fractures were recorded in Geneva in 2981 women and 822 men 50 years and older. Over this 10-year period, the age-adjusted incidence of hip fractures, standardized to the 2000 Geneva population, decreased significantly by 1.4%/year in women (p = 0.021), but remained stable in men (+0.5%/year, p = 0.66), suggesting a reversal of the previously observed secular trend.