Background <p>The postoperative recovery of patients with femoral neck fractures is often affected by various factors, and the mechanism of action of liver function status has not yet been fully elucidated. Objectives: It aimed to investigate the impact of different liver function statuses on perioperative indicators, levels of inflammatory factors and incidence of complications in patients with femoral neck fractures. Methods: 104 patients with femoral neck fractures were selected and divided into normal group (NG, 40 cases), mild impairment group (MIG, 38 cases) and moderate impairment group (MOG, 26 cases). Perioperative indicators were recorded, and the levels of inflammatory factors, immunoglobulins and bone metabolism indicators were detected before and 14 days after surgery. The occurrence of complications was also observed. Results: The MOG had markedly higher levels of surgical blood loss and hospital stay duration than the other two groups; The levels of pro-inflammatory factors in the MOG were markedly higher as against the other groups (<i>P</i> &lt; 0.01). Bone turnover activity in the MOG was markedly weakened; The incidence of deep vein thrombosis (DVT) and heterotopic ossification in the MOG was markedly increased (<i>P</i> &lt; 0.05). Conclusion: The degree of liver function impairment is markedly associated with poor postoperative recovery in patients with femoral neck fractures, with the mechanism involving dysregulation of inflammatory responses and abnormal bone metabolism. Clinical attention should be given to liver function assessment, as it holds predictive value for postoperative recovery in patients with femoral neck fractures.</p>