Objective To investigate the clinical effect of perioperative electroacupuncture intervention on postoperative delirium (POD) in hip replacement surgery patients.Method One hundred and twenty-eight patients who would undergo hip replacement surgery were randomly allocated to treatment and control groups, 64 cases each. The treatment group received perioperative electroacupuncture and the control group, routine preoperative preparation and postoperative treatment. Serum S100β protein concentration was measured in the two groups of patients at one day before, the end of and one day after surgery. The incidences of POD were compared between the two groups at one, two and three days after surgery.Result There was a statistically significant difference in the incidence of POD between at one day after surgery and recovery from anesthesia in the two groups (P<0.01). In the treatment group, the incidence of POD was significantly lower at two and three days than at one day after surgery (bothP<0.05) and at three days than at two days after surgery (bothP<0.05). There was a statistically significant difference in the incidence of POD between the treatment and control groups at different time points (recovery from anesthesia, and one, two and three days after surgery) (P<0.01). In the treatment group, there was a statistically significant difference in S100β protein concentration between at one day after and the end of surgery (P<0.05). There was a statistically significant difference in S100β protein concentration between the treatment and control groups at the end of and one day after surgery (P<0.05).Conclusions Perioperative electroacupuncture treatment can effectively decrease postoperative incidence of delirium and its duration in hip replacement surgery patients.