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Fall-induced injuries and resulting deaths are a serious health problem among older adults. The most common risk factors for falls in older adults are muscle weakness, gait deficiencies, and balance deficits. Patients with end-stage hip osteoarthritis (OA) also have many hip dysfunctions, and these all have the potential to increase the risk of falls. However, the incidence and risk factors for falls in patients with end-stage hip OA remain unclear. The aim of this study was to determine the incidence of falls in women with end-stage hip OA and to identify risk factors for falls in this patient population.This study was a cross-sectional analysis. One hundred fifty-three women with end-stage hip OA (mean age = 64.0 years) and 112 age-matched healthy women (mean age = 64.1 years) were analyzed using available data. All participants were examined for the number and circumstances of falls in the past year. The circumstances of falls included the location, time, direction, cause, and injury. We examined the outcome of hip function, ambulatory ability, physical activity, and limping severity in women with end-stage hip OA. Multivariate logistic regression analysis was used to identify factors influencing falls in women with hip OA.The incidence of at least 1 fall in the past year was significantly higher in women with end-stage hip OA (30.1%) than in healthy women (12.5%) (P < .001). Falls in women with end-stage hip OA were most often caused by tripping and falling forward during the daytime. The majority of falls (65.2%) resulted in injuries and 13.0% resulted in fractures. The occurrence of a fall significantly correlated with limping (odds ratio = 3.26, 95% confidence interval = 1.49-7.14, P = .003) and knee extensor muscle strength (odds ratio = 0.22, 95% confidence interval = 0.05-0.85, P = .029).Women with end-stage hip OA have an increased risk of falls and fall-induced injuries. The prevention of falls in this vulnerable population should be a priority among health care practitioners. In particular, women who are limping and have reduced lower knee extensor strength should take care to avoid falls.