Hip fractures are a major cause of morbidity and mortality, and almost all occur after a fall.1 In the next 50 years the number of hip fractures will probably increase greatly. About 20% of people who fracture their hips are dead within a year, and many of those who recover from hip fracture require additional assistance in daily living. Population data tend to obscure the personal impact of falls and hip fracture. Objective measures of function, such as activities of daily living and subjective utility based measures of health related quality of life, can express the personal dimension. Hip fracture adversely affects health related quality of life, with greater physical recovery reflected in better quality of life. Thus, health related quality of life is an important outcome for studies attempting to reduce the number of falls or their consequences. As part of an ongoing randomised trial (the community hip protector trial) that is examining the effectiveness of hip protectors in older women living in the community we sought to estimate the utility (preference for health) associated with falls that cause a fear of falling or hip fracture in older women.