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 elderly patients undergoing cardiac surgery has received increasing attention from clinicians. This article briefly describes the assessment methods of preoperative frailty, reviews the impact of frailty on the clinical outcomes after cardiac surgery, such as increasing the incidence of adverse prognosis and postoperative complications, reducing the postoperative quality of life of patients, and increasing medical costs, and summarizes the intervention and management methods for elderly patients with heart disease and frailty, which is helpful to clarify the goals of intervention and treatment and can improve the clinical prognosis and quality of life of patients.