Objective To systematically analyze the risk factors of delirium in elderly patients after hip arthroplasty, and to provide a reference for clinical nursing practice. Methods Such databases as PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and SinoMed were searched to retrieve relevant publications published from database inception to November 1, 2022.Two researchers independently performed literature screening,data extraction, and methodological quality appraisal.RevMan 5.4 was used for Meta-analysis. Results A total of 23 publications were included,involving 19 298 patients.Metaanalysis revealed that age, male, femoral neck fracture, postoperative hypoxemia, diabetes, stroke history, dementia/preoperative cognitive impairment, general anesthesia, ASA score, length of operation, postoperative VAS pain score, hemoglobin, time from injury to operation ＞3 d were the risk factors of delirium following hip arthroplasty in the elderly （all P＜0.05）. Conclusion Delirium after hip arthroplasty in the elderly is subjected to multiple factors. Medical staff should screen and take intervention early on according to the risk factors of delirium.However, due to the limitations of the included studies, the above conclusions need to be verified by more high quality studies.