Introduction: Hip fractures are a common pathology among older adults, often accompanied by significant complications such as delirium, a geriatric syndrome associated with prolonged hospitalization, reduced functional recovery, and decreased overall survival rates. This study aims to determine the incidence of delirium and its correlation with various factors during hospitalization, as well as its impact on short-, medium-, and long-term survival. Methodology: A retrospective cohort study was undertaken to examine hospital admissions of individuals aged 70 years or older diagnosed with hip fractures at the Hospital Universitario La Ribera in Alzira, Valencia, from January 2012 to December 2021. Results: A total of 3226 patients were recruited, mean of 85 years, 73.7% females, 26.3% males. Delirium was observed in 10.9% of patients during hospitalization (68.8% females, p = 0.029). Patients diagnosed with delirium exhibited a greater prevalence of dementia (25.2%, p < 0.001) and chronic kidney disease (14.7%, p = 0.018). Delirium was also significantly associated with older age (mean 86.5 years [SD 5.6], p < 0.001), increased number of complications (mean 1.4 [SD 1.6], p < 0.001), cardiac complications (9.1%, p = 0.036), anemia (21.7%, p < 0.001), and urinary tract infections (7.4%, p < 0.001) during hospitalization. Furthermore, patients with delirium experienced a prolonged hospital stay (mean 9 vs. 7.9 days, p < 0.001) and significantly higher short-, medium-, and long-term mortality rates. Discussion: The study findings underscore a significant association between delirium and comorbidities, complications, and mortality. Early identification of patients at risk for delirium will allow us to implement targeted interventions focused on prevention to enhance patient outcomes.