We examined the relationship of the length of stay and the day of initiating partial weight bearing to patients' level of ambulatory ability at 3 months after hip fracture surgery in Japan and the USA. The participants were patients aged ≥ 65 years who had undergone hip fracture surgery between August 2005 and September 2007. The data were collected from three hospitals in Japan and two hospitals in the USA. The participants received questionnaires pertaining to patient health outcomes after discharge. One-hundred-and-forty-nine patients in Japan and 88 patients in the USA completed the questionnaire. In Japan, the length of stay before surgery was longer and partial weight bearing after surgery was initiated later, compared to the USA. This independently predicted a lower level of ambulatory ability at 3 months after surgery. Assessing the reasons for delaying surgery and partial weight bearing is important in Japan. Encouraging ambulation with weight bearing at the earliest possible time is essential for patients to maintain their ambulatory ability after hip fracture surgery. Prospective studies using a large sample and/or intervention studies are required to determine the causal effect on ambulatory ability.