Rationale:Currently, there are no clear guidelines to determine whether and when to perform surgical hip repair in patients with acute stroke and hip fracture.Patient concerns:In this case report, we report a case of 75-year-old woman admitted with left hip pain and limited mobility for 1 month.Diagnoses:Patient had a history of acute cerebral infarction 42 days ago, and diagnosed with a left intertrochanteric fracture at another hospital 30 days ago.Intervention:Patient was treated with closed reduction and internal fixation with proximal femoral nail anti-rotation.Outcomes:At 2-year follow-up, the patient’s basic function was restored. The fracture healed well, and the Harris hip score was 75.Lessons:Without consistent guidelines, individualized treatment strategies including surgical methods and timing of surgery should be made to weigh the risks and benefits for patients with acute stroke and intertrochanteric fractures.