Hip fractures place a major and increasing burden on health services in Western countries. Reported incidence rates vary considerably from one geographic area to another. No published data are available for Switzerland or surrounding countries, but such descriptive indicators are indispensable in orienting national or regional policies. To fill this gap and to assess the similarity of hip fracture incidence in Switzerland and other countries, we collected data from several sources in 26 public and private hospitals, in the Canton of Vaud (total population: 538,000) for 1986, which allowed us to calculate the incidence (for people over twenty years old) and assess related parameters. 577 hip fractures were identified among the resident population, indicating a crude average annual incidence rate of 140 per 100,000 (95% confidence interval: 128, 152). Corresponding rates for males and females were 58 (47, 68) and 213 (193, 232). Standardized rates and international comparisons show that Swiss rates are slightly lower than those of most industrial countries. More detailed results of relative risks for various study variables are presented and the pathogenesis of hip fractures is discussed.