Hip fractures in elderly patients significantly burden health and healthcare costs. Effective pain management is crucial for optimal recovery, prompting the exploration of innovative strategies like peripheral nerve blocks (PNBs). This review investigated the clinical and economic impact of PNBs on geriatric patients undergoing hip fracture surgery. A systematic review identified relevant research on PNB use in this population, searching databases like PubMed, Cochrane, and others for studies published before September 2023. The findings revealed several potential benefits associated with PNBs, including targeted pain control, decreased opioid dependence, and facilitated earlier mobilization. Notably, the analysis highlighted a dual impact, with PNBs demonstrating potential clinical advantages like shorter hospital stays and fewer complications alongside their costs. However, the evidence of their influence on healthcare costs remains inconclusive. Despite the uncertainty surrounding cost-effectiveness, the overall trend suggests positive clinical outcomes associated with PNBs, including improved recovery and reduced opioid reliance. These potential benefits could translate to a positive impact on healthcare resource utilization. In conclusion, PNBs show promise for improved clinical outcomes and potentially reducing healthcare resource utilization. To solidify cost-effectiveness, future studies should pinpoint economic benefits and refine PNBs use. A more thorough analysis is needed to confirm these financial advantages.