Objective To explore the risk factors of recurrent fracture in elderly patients with osteoporotic fracture in order to provide theoretical basis for prevention of recurrent fracture. Methods The clinical data of 1 315 inpatients (aged ≥60 years) with osteoporotic fracture admitted in Department of Orthopaedics of Second Affiliated Hospital of Dalian Medical University from January 2015 to December 2019 were collected. According to the previous history of fracture, they were divided into first fracture group and refracture group (n=277). General data and blood biochemical parameters were compared between the two groups. SPSS statistics 25.0 was used to perform the statistical analysis. Student′s t test, Mann-Whitney U test or Chi-square test was employed for intergroup comparison depending on data type. Multivariate logistic regression analysis was adopted to analyze the risk factors affecting refracture in elderly patients with fragility fracture. Results The patients from the first fracture group were younger [(73.31±9.01) vs (76.26±8.11) years]and had lower proportion of females (74.40% vs 83.00%) than those in the refracture group (P<0.05). The most common causes of fracture were fall (81.29%), no inducement (7.07%), low-back load (6.24%) and change in body posture or sprain (5.40%). The overall diagnosis rate of osteoporosis was 13.00% in elderly patients with osteoporotic fracture during hospitalization. The utilization rate of calcium, vitamin D and bisphosphate drugs was 12.50%, 8.80% and 4.90%, respectively. The risk factors of refracture include advanced age (OR=1.022), elevated blood phosphorus (OR=3.220), low hemoglobin (OR=0.983), hypoglycemia (OR=0.938), low serum creatinine (OR=0.995), hypoalbuminemia (OR=0.950) and complicated with chronic obstructive pulmonary disease (COPD) (OR=2.214). Conclusion The elderly with advanced age, higher blood phosphorus, lower hemoglobin, hypoglycemia, low serum creatinine, hypoalbuminemia and complicated with COPD are at high risk for refracture. The diagnosis and treatment rates of osteoporosis are quite low in the elderly patients with osteoporotic fractures during hospitalization.