In the search for effective and safer alternatives to opioids for managing postoperative pain in hip fracture patients, fascia iliaca compartment block (FICB) has emerged as a promising candidate. RCT evidence evaluating the postoperative use of FICB for hip fracture patients had six trials assess pain at 4, 12, 24, and 48 hours, opioid consumption at 24 hours, and safety outcomes including nausea/vomiting, hypotension, and pruritus. Across all measures, FICB showed no superiority or inferiority compared with active controls. Evidence certainty was very low due to risk of bias, imprecision, and heterogeneity in interventions and comparators. While current findings suggest no clear benefit, higher-quality RCTs with larger samples and standardized protocols are needed to determine the true efficacy and safety of postoperative FICB.