Sixty patients aged ≥65 years undergoing hip hemiarthroplasty for femoral neck fractures were randomized to receive a suprainguinal fascia iliaca compartment block either preoperatively (n=30) or postoperatively (n=30). The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 hours. Secondary outcomes included Nursing Delirium Screening Scale (N-DSS), postoperative nausea/vomiting (PONV), and opioid consumption. Outcomes were assessed up to 24 hours. Overall, the results showed that preoperative blocks resulted in higher QoR-15 scores and greater reductions in severe pain compared with postoperative blocks, with no differences in delirium, PONV, or total opioid use. These findings suggest that performing the block preoperatively improves short-term recovery quality in elderly hip fracture patients.