Objective To identify the potential categories of self-awareness of falls in elderly patients with hip osteoarthritis (HOA), and to analyze the characteristics and influencing factors of different categories. Methods A cross-sectional study was conducted on elderly patients with HOA who were hospitalized in the orthopedic ward of West China Hospital of Sichuan University between February and April 2026 by convenience sampling. The participants were investigated by general information questionnaire, Self-awareness of Falls in Elderly scale, Fall Risk Self-rating Scale for the Elderly, Barthel index scale for self-care ability assessment, Family Care Index Questionnaire, Generalized Anxiety Disorder-7 self-rating scale and Berg Balance Scale. The potential categories of self-awareness of falls were divided by potential profile analysis, and the influencing factors of self-awareness of falls were explored by single factor analysis and multinomial logistic regression analysis. Results A total of 301 elderly patients with HOA were included. The self-awareness of falls of elderly patients with HOA could be divided into three potential categories: “low alertness and low cognition” “medium alertness and high cognition” and “high alertness and high cognition”. Compared with “high alertness and high cognition”, patients with lower education level [odds ratio (OR)=0.199, 95% confidence interval (CI) (0.097, 0.411), P<0.001] and fewer chronic diseases [OR=0.654, 95%CI (0.453, 0.945), P=0.024] were more likely to belong to “medium alertness and high cognition”; patients with good self-care ability [OR=0.346, 95%CI (0.192, 0.623), P<0.001], good balance ability [OR=0.119, 95%CI (0.048, 0.293), P<0.001], fewer chronic diseases [OR=0.478, 95%CI (0.292, 0.781), P=0.003], and low degree of pain [OR=0.448, 95%CI (0.276, 0.728), P=0.001] were more likely to belong to “low alertness and low cognition”. Conclusions There is group heterogeneity in the self-awareness of falls of elderly patients with HOA. In clinical work, medical staff should formulate personalized intervention strategies for different types of patients according to their different characteristics.