Objective To explore the change of fear of falling experience in elderly patients with fall-induced fracture, so as to provide reference for developing effective and targeted nursing intervention. Methods The longitudinal qualitative research method was used, and 16 elderly patients with fall-induced fracture in orthopedic department were selected by purpose sampling to conduct semi-structured interview, then the interview data were analyzed cross-sectionally and longitudinally. Results A total of 3 themes and 8 sub-themes were extracted:change in emotional experience of fear of falling (negative emotion development, positive emotion regulation), change in cognitive experience of fear of falling (diversification of causes, decreased self-efficacy), change in coping experience of fear of falling (maintain cautious attitude, build confidence in recovery, improve knowledge reserve, seek external support). Conclusion The experience of fear of falling in the elderly is a complex phenomenon with dynamic change.Clinical medical staff should identify the elderly with fear of falling early and conduct preventive nursing intervention through a multidisciplinary team.