Objective To explore the practice effect of a fall prevention program for the hospitalized elderly based on patients engagement framework. Methods A total of 58 elderly inpatients admitting from January to June 2019 were taken as a control group, and another 58 elderly inpatients admitting from July to December 2019 were regarded as an intervention group.The control group received routine fall prevention strategy, while the intervention group received a fall prevention program based on patient engagement framework, which was consisted of informing, participating, empowering, collaborating and electronic information supporting. Before and after the intervention, the knowledge, attitude, practice level of participating fall prevention, fall efficacy level and fall incidence between the two groups were compared. Results After the intervention, the knowledge, attitude, practice level of participating fall prevention and fall efficacy level of the intervention group were significantly higher than those of the control group （P＜0.05,P＜0.01）.During hospitalization, nobody fell in the intervention group, while 2 patients fell in the control group. Conclusion Practice of the fall prevention program for the hospitalized elderly based on patient engagement framework improves patients′ knowledge, attitude and practice level of participating fall prevention and their level of fall efficacy, then reduces fall incidence and ensures patient safety.