Objective To investigate the correlation between the change of muscle tissues and bone mineral density (BMD) in elderly women with hip fracture, with consideration of the impact of muscle mechanics on bone mass changes. Methods A total of 79 elderly patients with hip fracture were selected as the fracture group, and 45 physical examination personnel as the control group. Analyze the total muscle mass, total body fat, trunk muscle mass, trunk fat mass, arm muscle mass, arm fat mass, leg muscle mass, leg fat mass, as well as BMD at the lumbar spine (L1-4), femoral neck, hip joint, and whole body. Results Muscle content and fat content of the whole body, upper limb and lower limb, fat content of the trunk, relative skeletal muscle index (SMI) and BMD of the whole body in fracture group were significantly lower than those in control group (P<0.05). The incidence rate of sarcopenia for elderly women in fracture group was higher than that in control group. BMD of femoral neck of the affected side was significantly lower than that of the intact side in women with intertrochanteric fractures. Logistic regression analysis found that SMI in elderly women with hip fracture was negatively correlated with age, and positively correlated with body mass index (BMI), BMD of the femoral neck and whole body. Conclusions The rate of sarcopenia was significantly higher in elderly patients with hip fracture, and SMI was closely related to BMD of the femoral neck and whole body. Therefore, sarcopenia should be highly emphasized in the prevention and treatment of osteoporotic fracture in elderly people.