Objective To observe the clinical effect of preoperative acupuncture on hypercoagulability of elderly patients with intertrochanteric fracture. Methods Sixty elderly patients with intertrochanteric fracture were evenly randomized into control group and acupuncture group. Both groups were treated with external application of Shangke Huangshui gauze on the affected region, and additionally the acupuncture group was treated with acupuncture on bilateral acupoints of Huantiao, Xuehai, Liangqiu, Zusanli, Sanyinjiao, and Taichong. The treatment for the two groups was performed from the hospitalized day to the day before operation. The parameters of thrombelastograph (TEG) before and after treatment and the occurrence of deep venous thrombosis (DVT) were observed . Results After treatment, the difference of TEG parameters of the control group was insignificant as compared with those before treatment (P>0.05). In the acupuncture group, the coagulation reaction time(R) and clot formation time(K) were significantly prolonged(P < 0.05) , and coagulation angle alpha (α), maximal amplitude (MA)of thrombus and clot strength (G) were significantly decreased (P <0.05), the effect being superior to that in the control group(P<0.05). Till the day before operation , 3 cases from the control group suffered from DVT, but none of acupuncture group suffered from DVT, the difference between the two groups being insignificant(P > 0.05). Conclusion Preoperative application of acupuncture can improve the hypercoagulability of elderly patients after hip fracture.