OBJECTIVES The aim of our study is to analyze the relationship between surgical delay over 24 hours and 30 days mortality following femoral neck fracture in the presence of different co-morbidities in patients aged over 60 years. METHODS Data were derived from the database of the National Health Insurance Fund Administration according to the ICD 10th revision's S7200 code. The study included patients aged over 60 years old discharged from inpatient care institutions following the primary treatment of femoral neck fractures. The patients with polytrauma were excluded from the study. In case of surgical delay six hours mortality was the reference. Data were evaluated according to sex, age, type of fracture, patient turnover of institutions, type of surgery, early complications, hospital type, day of operation. The following co-morbidities were included into the analysis: C00-C97, D60-D64, E10-E16, F00-F99, G20-G26, G80-G83, I10-I15, I20-I25, I30- I52, I60-I69, I70, J00-J22, J40-J47, L89, N30-N39). Statistical analysis has been performed by logistic regression (Odds Ratio(95%CI), p<0,05). RESULTS Altogether 3783 patients were involved into the study. Surgical delay (24h+/0-6h) OR=1.5009, p=0.0095. The following co-morbidities (ICD codes with OR and p value) proved to be statistically significant predictors: C00-C97: 2,6381(0.0274), G80-G83: 2.5984(0.0224), I20-I25: 1.6125(0.0438), I30-I52: 2.2758(0.0246), I70: 1.7281(0.0328), J00-J22: 2.2884(0.04), J40-J47: 2.3204(0.0141). CONCLUSIONS Longer than 24 hours surgical delay significantly increased the risk of 30 days mortality compared to 6 hours delay. The longer than 24 hours surgical delay of treatment of elderly femoral neck fracture proved to be statistically significant predictors of 30 days mortality: malignancies, cerebral paralyzed disorders, ischemic and other heart diseases, arteriosclerosis, infections of the upper and lower respiratory system and chronic diseases of the lower respiratory system. In order to decrease the risk of early mortality it is essential strive after earliest surgical treatment with special respect the high risk patient group with co-morbidities.