Hip fractures in the elderly population are associated with considerable complications such as morbidity, mortality, and enduring functional deterioration. Thus, they render perioperative management an essential element of strategies aimed at fostering healthy aging. Regional anesthesia (RA) and general anesthesia (GA) constitute the two predominant methods for the surgical intervention of hip fractures; however, the most effective technique remains a subject of ongoing scholarly debate. This research review seeks to systematically assess and compare regional anesthesia to general anesthesia in elderly patients undergoing surgical treatment for hip fractures, focusing on perioperative safety, mortality rates, functional recovery, cardiopulmonary issues, and cognitive outcomes to understand their implications for encouraging healthy aging. A concentrated narrative review of pertinent literature published from the year 2020 onwards was executed, utilizing databases such as PubMed and Google Scholar. Studies were included for consideration if they provided a comparative analysis of regional anesthesia and general anesthesia in adults aged 65 years and above undergoing surgical procedures for hip fractures. Recent extensive randomized trials indicate that spinal anesthesia does not show an advantage over general anesthesia concerning survival rates, functional recovery, or significant postoperative results, including the return to ambulation at a 60-day follow-up. Meta-analyses indicate that both anesthetic methods demonstrate similar safety profiles; however, regional anesthesia might lead to reduced intraoperative blood loss, shorter operative times, and slight decreases in hospital stay for certain patient groups.