A retrospective study investigated the effect of continuous low-dose norepinephrine (NE) infusion on hypotension during total hip arthroplasty in patients over 80 years of age. The study compared the NE infusion group with conventional hypotension treatment. NE infusion was found to be associated with a lower burden of intraoperative hypotension as measured by multiple markers. The NE group also had a lower incidence of postoperative delirium and a shorter length of hospital stay. Multivariable analysis confirmed that the NE strategy was independently associated with a lower likelihood of postoperative delirium. The study highlights the potential benefit of continuous low-dose NE infusion for elderly patients undergoing this type of surgery. Because of the retrospective design, the results should be interpreted with caution.