To evaluate the effect of fracture liaison service (FLS) on postoperative mobility and 2-year mortality in elderly patients with intertrochanteric femur fractures. A retrospective cohort study was conducted including patients (≥ 60 years) who underwent surgical treatment for intertrochanteric fractures at Handan Central Hospital from January 2018 to January 2020. Participants were divided into pre-FLS (group A, n = 60) and post-FLS implementation (group B, n = 62) groups. Anti-osteoporotic drug prescription rates, medication adherence, re-fracture incidence, functional ambulation classification (FAC), Barthel index scores, and 2-year mortality were compared between groups. A significant increase in anti-osteoporotic drug prescription rates is observed in group B(96.8%) compared to group A (11.7%) (P < 0.001). Higher medication adherence is demonstrated in group B (7.29 ± 1.05) than in group A (6.55 ± 1.12) at 12 months postoperatively (P < 0.001). Within the 2-year follow-up, the re-fracture incidence is recorded as 3.2% (group B) versus 6.7% (group A) (P=0.646), while mortality rates are 9.7% (n = 6) in group B and 18.3%(n = 11) in group A (P = 0.217). Regarding functional recovery, progressive improvements in Barthel index and FAC scores are identified across all time points (12 months > 6 months > 1 month > preoperative; P < 0.05 for intra-group comparisons), with no significant inter-group differences detected at baseline. In summary, the implementation of FLS enhances anti-osteoporotic treatment compliance, improves postoperative mobility, and reduces mortality risk in elderly patients with intertrochanteric fractures. These findings support integrating FLS protocols into standard postoperative care.