Objective <p>To evaluate the association between red cell distribution width (RDW) on admission and preoperative deep venous thrombosis (DVT) in older adult patients with hip fractures.</p> Methods <p>Older adult patients with hip fractures were screened from January 2015 to September 2019. A multivariate logistic regression model was used to identify the association between RDW on admission and DVT in these patients. Sensitivity analysis was used to test the robustness of the results.</p> Results <p>A total of 1686 patients were included in this study. The multivariate logistic regression model showed that RDW was associated with DVT after adjusting for confounders (odds ratio (OR) = 1.03, 95% confidence interval (CI): 1.01–1.05; <i>P</i> &lt; 0.001). An increase in one RDW was associated with a rise of 3% in DVT in older adults with hip fractures. In addition, we found that the linear association was stable in sensitivity analysis.</p> Conclusions <p>The RDW on admission was associated with preoperative DVT in hip fractures.</p> Trial registration <p>ChiCTR2200057323.</p>