Background <p>Proximal femur fractures in elderly patients are determined by patient age, femoral morphometry, and radiographic bone quality. The Dorr classification, Singh index, and the canal-to-bone ratio (CBR) are commonly used to evaluate cortical integrity and trabecular structure.</p> Methods <p>A retrospective analysis was performed on 322 patients with proximal femur fractures. Radiographic parameters included collodiaphyseal angle (CDA), center–edge angle (CEA), femoral head diameter (FHD), femoral neck diameter (FND), femoral neck length (FNL), femoral offset (FO), and cortical widths at supra- and infra-minor trochanter levels. Bone quality was assessed using the Dorr classification, Singh index, and CBR. Statistical analyses comprised the Shapiro–Wilk test for normality, Kruskal–Wallis test, Dunn’s post hoc comparisons with Bonferroni correction, and chi-square test for categorical variables. Interobserver reliability was verified.</p> Results <p>Age (<i>p</i> = 0.001), CDA (<i>p</i> = 0.020), FNL (<i>p</i> = 0.005), and FO (<i>p</i> = 0.002) differed significantly by fracture type. Subtrochanteric fractures occurred more often in relatively younger patients (mean age: 73.3 ± 11.0&#xa0;years) and were associated with lower FNL and FO values. Dorr Type C morphology showed a significant association with basicervical fractures (χ² = 15.93, <i>p</i> = 0.043). The Singh index (<i>p</i> = 0.0005) and CBR (<i>p</i> = 0.0045) were also significantly related to fracture patterns, reflecting trabecular bone loss and cortical thinning, particularly in subcapital and subtrochanteric fractures.</p> Conclusion <p>Proximal femoral morphometry and bone quality indices may help anticipate fracture localization and support clinical decision-making in elderly hip fractures.</p>