Objective To evaluate the effect of ATP binding cassette, sub‑family B (MDR/TAP), member 1 (ABCB1) C1236T gene polymorphism on the analgesic effect of sufentanil in patients with femoral fracture. Methods This article selected 372 patients who underwent femoral fracture surgery under intrathecal anaesthesia, and collected venous blood for ABCB1 gene polymorphism testing before surgery. The patients were divided into wild‑type (CC) group, heterozygous (CT) group, and mutant homozygous (TT) group according to their genotypes. The patients were placed intravenous analgesic pumps at the end of the surgery. Observe and record the patients' information including general information , the Numerical Rating Scale (NRS) scores on day 1, 3 and 7 postoperatively, the number of presses by the patient controlled analgesia (PCA) pump, the amount of sufentanil consumed by the analgesic pump, the time when the patients began to experience pain after returning to the ward postoperatively and the postoperative adverse event (nausea, vomiting and excessive sedation). Results Among the 372 patients, genotype ratios were complied with the Hardy‑Weinberg law of genetic equilibrium. There was no statistical difference in the general information (all P>0.05). Compared to the patients CC and CT groups, patients in the TT group had high postoperative 1 d NRS scores, high numbers of PCA presses, high analgesic pump sufentanil consumption, and high incidence of over‑sedation (all P<0.05). The patients in the TT group began to experience pain earlier after returning to the wards (P<0.05). In the meantime, the patients in the CT group had higher number of PCA presses, and analgesic pump sufentanil consumption than the patients in CC group (all P<0.05). There was no statistical difference among the groups in the incidences of postoperative 3 d NRS, 7 d NRS, and postoperative nausea and vomiting (all P>0.05) Conclusion The ABCB1 C1236T gene polymorphism is one of the genetic factors affecting the individual differences in the analgesic effect of sufentanil in the early postoperative period.