Hip fractures are a significant health concern among the elderly population, characterized by elevated mortality rates, prolonged recovery periods, and substantial postoperative complications. Osteoporosis (OP), a key determinant of increased hip fracture risk and poor recovery outcomes in older adults, leads to deterioration of bone microarchitecture, reduced bone mineral density, and heightened skeletal fragility. This condition substantially impacts patients’ postoperative survival and overall quality of life. Recent advancements in OP management have been notable, with an increasing development of novel pharmacological agents. Teriparatide, which uniquely stimulates bone formation rather than merely suppressing bone resorption, has demonstrated efficacy in mitigating OP-related symptoms and facilitating fracture recovery. Currently, teriparatide is extensively employed in the management of osteoporotic hip fractures. This article presents a narrative review of the etiological factors underlying osteoporotic hip fractures, associated postoperative mortality, and the therapeutic application of teriparatide in fracture management. The objective is to establish a theoretical foundation that may guide the development of enhanced treatment strategies and pharmacological interventions for osteoporotic fractures.