Objective To explore the effect of home-based simulation training on improving the recovery of elderly hip replacement patient. Methods A total of 162 elderly hip replacement patients were divided into a control group of 80 patients and an intervention group of 82 patients chronologically. The control group received rehabilitation guidance according to routine orthopedic care, while the intervention group additionally received a whole-course home-based simulation training including daily living and travel paths provided by advanced primary nurses. The Harris hip function score and Barthel Index in both groups were evaluated at admission, 1, 3, and 6 months after operation. Results The Harris hip function score and Barthel index score of the intervention group were significantly higher than those of the control group (P<0.01 for all). Conclusion Implementation of home-based simulation training is beneficial to promote recovery of elderly patients after hip replacement, and improve their daily living ability.