Objective To explore the comprehensive nursing care in elderly patients with hip replacement. Methods A total of 68 elderly patients with hip replacement was randomly divided into experimental group ( routine nursing and comprehensive nursing care ) and control group ( routine nursing ) . After intervention, we compared the satisfaction of patients and the incidence rate of complication such as the score of hip Harris score, infection, constipation and electrolyte disturbances. Results The scores of joint motion range, function, pain and deformity were (4. 35 ± 0. 44),(40. 91 ± 2. 30),(40. 58 ± 1. 18) and (3. 60 ± 0. 23) in the experimental group, compared with (3. 88 ± 0. 18),(39. 32 ± 2. 48),(39. 00 ± 1. 37) and (3. 41 ± 0. 36) in the control group (t=5. 689,2. 379,5. 114,2. 512, respectively;P<0. 05). While the incidence rate of infection, electrolyte disturbances, constipation and other other complication were 2. 9%, 2. 9%, 5. 9%, 5. 9% in the experimental group, these of the control group were 17. 6%, 17. 6%, 23. 5%, 23.5% (χ2 =3. 981,3.981,4. 221,4. 221, respectively; P < 0. 05). After intervention, the scores of fundamental nursing, specific nursing, attitude of service, health education and total satisfaction degree were (28. 88 ± 0. 91),(29. 06 ± 0. 81),(18. 50 ± 1. 19),(18. 65 ± 1. 04),(95. 18 ± 2. 89), all that were higher than those in the control group (P<0. 05). Conclusions The comprehensive nursing care for elderly patients with hip replacement can contribute to rehabilitative quality after operation, minimize complication incidence and promote elderly satisfaction.