Preoperative frailty is one of the most common clinical problems in perioperative elderly patients. Many studies have shown that preoperative frailty is closely related to the occurrence of perioperative adverse events, such as prolonged hospital stay, postoperative pain, postoperative depression, postoperative delirium, etc. The mechanism of preoperative frailty and perioperative adverse events is not fully understood at present, which may be related to the dysfunction of multiple system functions. Reasonable evaluation, intervention or treatment for preoperative frailty may help to reduce the occurrence of perioperative adverse events. In this paper, typical perioperative adverse events such as prolonged hospital stay, postoperative cognitive dysfunction, postoperative depression and postoperative pain were selected, and the relationship between preoperative frailty and perioperative adverse events, possible related mechanisms and intervention strategies were reviewed.