Objective:To investigate the status of preoperative frailty in elderly patients undergoing neurosurgery and explore its influencing factors.Methods:A total of 135 elderly patients undergoing neurosurgery in Xuanwu Hospital Capital Medical University from April 2020 to March 2021 were selected as the research objects by the convenient sampling method. The survey was conducted using the general information questionnaire, Clinical Frailty Scale, Short-Form Mini Nutritional Assessment, Barthel Index Evaluation Scale and Geriatric Depression Scale-15. Logistic regression analysis was used to screen the influencing factors of preoperative frailty in elderly patients undergoing neurosurgery.Results:A total of 135 questionnaires were sent out, and 123 were effectively collected, with an effective recovery rate of 91.1%. Among 123 elderly neurosurgical patients, the incidence of preoperative frailty was 32.5% (40/123) . The results of logistic regression analysis showed that female, malnutrition and self-care ability were the influencing factors for preoperative frailty in elderly neurosurgical patients ( P<0.05) . Conclusions:The incidence of preoperative frailty in elderly neurosurgical patients is relatively high, which should be actively evaluated clinically, considering the gender difference of patients, improving the nutritional status of patients, effectively helping the self-care dependent population and improving the prognosis of patients.