© 2016, Springer-Verlag Berlin Heidelberg.Introduction: Data on the incidence of preoperative deep vein thrombosis (DVT) in patients, who are waiting for elective hip replacement for femoral neck fractures, are limited. Our primary goal was to determine the prevalence and risk factors of preoperative DVT in acute hip fracture patients awaiting hemi- or total hip arthroplasty using venography. The secondary objective was to find a possible relationship between preoperative and postoperative DVT. Methods: We enrolled 119 consecutive patients with subcapital femoral neck fracture, who were awaiting hip replacement at our institution. All of them received venography before and after surgery. We used univariate analysis and multivariate logistic regression analysis to identify the risk factors for preoperative DVT. Results: Of the patients, 35 patients (29.4 %) developed DVT in affected limbs before surgery. Both long duration of immobilization and increased level of d-dimer were associated with preoperative DVT independently. Intriguingly, 66.7 % of patients who were diagnosed with DVT after surgery had thrombus in the same location, as they did before surgery. Conclusions: We identified the high incidence and risk factors of preoperative DVT in patients awaiting elective surgery for femoral neck fractures. The majority of patients diagnosed with DVT postoperatively had already had thrombus before surgery.