Elderly patients with hip fractures often have many comorbidities and complications. Improper anesthesia and perioperative management can significantly increase the fatality rate. This article introduces the perioperative management experience of an elderly patient with a hip fracture complicated by dilated cardiomyopathy. In this case, the patient was an elderly female with a hip fracture combined with coronary artery disease, dilated cardiomyopathy, heart valves disease (mitral, aortic, and tricuspid valve insufficiency), interstitial pulmonary fibrosis, and a history of cerebrovascular disease. The surgery was performed under nerve block with Taylor spinal anesthesia, and the patient completed the procedure smoothly and recovered well afterward.