OBJECTIVES: The aim of the study is to evaluate, that the pharmacologic treatment for osteoporosis after primary hip fracture can reduce the risk of subsequent femoral neck fracture in patients aged over 60 years? METHODS: In this retrospective study the data derive from the financial database of the Hungarian National Health Insurance Fund Administration. The study includes patients over 60 years following primary treatment of femoral neck fracture (S7200) discharged from inpatient care institutions in 2000. Pathologic hip fractures, fractures that emerged from high-energy trauma, fractures that happened in hospitals, and patients who died within ½ years after primary hip fracture were excluded from the analysis. The follow up period was 8 years. We evaluated data according to sex, age, type of living place, type of hospital treated the primary fracture, type of primary femoral neck fracture, absence or presence of accompanying diseases, type of surgical intervention for primary fracture, and antiosteoporotic pharmacologic treatment after primary fracture. The effects of prognostic factors were evaluated by Cox proportional hazard regression analysis (HR, 95 % CI, p) RESULTS: The 2778 patients were observed for 13,488.92 person-years. During the observation period 320 second hip fracture (11.5 %) were identified, giving an overall incidence of 0.024 per person-year. The significant predictors (0.05>p) are presented: Gender: female/male HR:1.5289; Age: 80-89y/60-69y HR:1.4910; Residence: capital/village HR:1.4980; Type of surgical intervention: arthroplasty/osteosynthesis HR:1.4136; Osteoporosis medication: duration<2years/none HR:0.5100, duration>2 years/none HR:0.5261. The references is marked with underline. CONCLUSIONS: The risk of second hip fracture was the highest in female, in older age-group, in patient after arthroplasty, in patient with capital residence and in patient without pharmacologic treatment for osteoporosis. In addition the osteoporosis medication can reduce the risk of subsequent femoral neck fracture.