Background <p>Fragility fractures of the femoral neck (NOF) are a growing concern in the “young elderly” (aged 65–84), a group experiencing the intersection of aging and active lifestyles. These fractures occur with minimal trauma due to weakened bones, primarily from osteoporosis. The management of such fractures in this population presents distinct challenges, requiring a balance between rapid recovery and the limitations imposed by aging physiology.</p> Management <p>The rising incidence of femoral neck fractures is linked to age-related bone loss and comorbidities like osteoporosis, sarcopenia, and chronic diseases. Women, due to post-menopausal bone loss, are disproportionately affected. Early surgical intervention (internal fixation, hemiarthroplasty, or total hip arthroplasty) is crucial for restoring mobility. Surgical complications such as avascular necrosis, fixation failure, and dislocation remain significant concerns. Rehabilitation involving early mobilization and osteoporosis management is essential for optimal recovery, though the risk of mortality and permanent disability remains elevated.</p> Conclusion <p>Fragility fractures in the young elderly require a multidisciplinary approach that combines prompt surgical intervention, targeted rehabilitation, and long-term osteoporosis management. Preventive strategies focused on bone health and fall prevention will be critical in reducing the incidence and improving outcomes for this population.</p>