An international, randomized, controlled trial was designed to compare accelerated surgery and standard care in hip fracture. This trial was conducted at 69 hospitals in 17 countries. Individuals were assigned randomly (1:1) through a central computerized randomization system applying randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. In this study, 27,701 individuals were selected, of whom 7,780 were eligible between March 14, 2014, and May 24, 2019. The results of this study indicated that accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care among individuals with a hip fracture.