A single-center retrospective study investigated the effect of ciprofol on the incidence of post-induction hypotension (PIH) in elderly patients undergoing total hip arthroplasty between August 2024 and July 2025. PIH was defined as mean arterial pressure ≤ 65 mmHg or a decrease of more than 30% from baseline within 20 minutes after induction of anaesthesia. Patients were divided into the ciprofal group and the propofol group, with baseline clinical characteristics being comparable between the groups. The incidence of PIH was significantly lower in the ciprofal group (36.4%) versus propofol (65.5%; absolute risk reduction 29.1%, 95% CI: 11.2–47.0%, p = 0.002). Subgroup analyzes confirmed consistent benefits of ciprofol in patients younger than 90 years, with aCCI ≤ 4, CFS ≤ 4, and baseline BP < 140/90 mmHg. The study suggests that ciprofol reduces the risk of PIH in elderly patients independent of baseline characteristics.