Frailty is a clinically more common geriatric syndrome characterized by decreased physiological capacity of multiple organ systems, thus increasing sensitivity to stressful events, with a high prevalence in geriatric surgical patients. Genetic factors, demographic and sociological factors, poor lifestyle, malnutrition, sarcopenia, anxiety, and depression are all risk factors for frailty, and the occurrence of frailty syndrome is the result of the interaction of multiple factors, including aging⁃related changes, genes and environment, and chronic diseases. Frailty is closely related to malnutrition, both of which share many pathophysiological pathways, including loss of body tissue and chronic inflammation, and both screening assessment tools also have overlapping indicators, such as weight loss and impaired physical function. Frailty is associated with adverse clinical outcomes, which can lead to disability and reduced function in elderly surgical patients, increased risk of death and postoperative complications, prolonged length of hospital stays, increased hospital costs, increased need for long⁃term care and poor quality of life. The effective intervention means for elderly surgical frail patients are exercise intervention and nutritional support. Exercise intervention should be progressive and personalized, with resistance exercise as the core, supplemented by aerobic exercise, balance and flexibility training. If more than 60% of the recommended energy and protein goals for elderly surgical patients cannot be met through diet alone, oral nutritional supplementation is preferred to improve malnutrition status.