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Background: As a vital issue in geriatric research, risk factors for falls were concluded to be multifactorial, and prevention has been mostly aimed at decreasing situational and environmental risks that cause and aggravate fall-related injuries, particularly within the institutions. While knowledge is limited about older patients' intrinsic determinants, the purpose of this study was to explore elderly Taiwanese's intrinsic risk factors associated with severe fall-related injuries. Methods: Between April 2011 and December 2013, medical records related to in-ward elderly patients' falls were retrieved from two teaching hospitals in the northern Taiwan area. A total of 244 elderly hospitalized patients' fall-related assessments were reviewed from the national hospital safety reporting system. Chi-square statistics and odds ratio calculations were performed to ascertain significant associations between risk factors and the severity of after-fall injuries. Results: Major risk factors resulting in fall-related injuries were found to be intrinsic and not situational or environment-related. Vertigo and weakness of the legs were both significant physical and behavioral determinants, and elderly cancer patients staying in oncological wards were more likely to have severe injuries after incidents of falls, compared with those in medical and surgical wards. Female gender was not discovered as a significant factor to affect the severity of falls. Conclusion: Elderly Taiwanese inpatients with existing intrinsic conditions of cancer, vertigo, and lower leg weakness were at high risk of falling, resulting in severe injuries. Additional research including controlled trials is necessary to further identify treatable, causal intrinsic risk factors for this elderly group.