BACKGROUND: Frailty is an important predictor of poor postoperative outcomes in elderly patients with gynaecologic cancer. However, the prevalence and risk factors for frailty in this population remain unclear. METHODS: This cross-sectional study was conducted simultaneously in three gynecology departments of a tertiary hospital in China between January and March 2024. The study recruited 126 hospitalised patients with gynaecologic malignancies who underwent surgery. The demographic and clinical characteristics and biochemical laboratory parameters of all patients were collected. The Edmonton Frailty Scale was used to assess the patient's frailty. Multivariate logistic regression model analysis was used to identify the influencing factors of frailty. RESULTS: The prevalence of preoperative frailty was 31 %. Univariate analysis showed significant differences between frail and non-frail groups in terms of age, body mass index, menopausal status, self-management ability, nutritional risk and activities of daily living (ADL) (all p <
0.05). Multiple logistic regression analysis identified older age (odds ratio [OR] = 1.27, 95%CI: 1.068-1.511, p = 0.007), ADL disability (OR = 3.184, 95%CI: 2.294-4.833, p = 0.010) and high nutritional risk (Nutritional Risk Screening 2002 score ≥ 3) (OR = 4.823, 95%CI: 1.422-16.816, p = 0.031) as risk factors for frailty. High self-management ability (OR = 0.918, 95%CI: 0.844-0.998, p = 0.046) was a protective factor against frailty. CONCLUSION: Nutritional support, activity exercise and improvement of patient self-management are potential intervention goals, and nurses should develop targeted prevention strategies based on identified risk factors to protect patient health.