Frailty is a common multi-dimensional clinical syndrome in the elderly，with diverse definitions. Most literature considers frailty as a non-specific state characterized by a decline in physiological reserves and increased vulnerability. As the number of elderly patients undergoing cardiac surgery increases，the impact of frailty on these patients has gained increasing attention from clinicians. This article briefly describes the assessment methods of preoperative frailty，and reviews the impact of frailty on the clinical outcomes after cardiac surgery，such as increased risks of adverse prognosis and postoperative complications，reduced the postoperative quality of life of patients，and higher medical costs. Additionally，it summarizes the intervention and management strategies for frail elderly patients with heart disease，aiming to clarify the goals of intervention and treatment，and enhance the survival outcomes and quality of life of patients.