Frailty is a biological syndrome characterized by decreased physiological reserve and vulnerability to stressors, and it has become a critical focus in cardiovascular medicine due to the aging and complex nature of patients. Over 20 frailty assessment tools have been developed, most focusing on core domains such as slow walking speed, weakness, inactivity, exhaustion, and shrinking. Prevalence of frailty ranges from 10% to 60%, depending on CVD burden and assessment tools. Frailty is associated with a relative risk of over 2 for mortality and morbidity in various cardiovascular conditions. It provides incremental prognostic insights and helps clinicians define optimal care pathways. Interventions like multidisciplinary cardiac rehabilitation are being tested to improve outcomes in frail patients. Frailty should not be seen as a reason to withhold care but as a means to deliver it more patient-centered. Frailty is linked to inflammatory biomarkers and subclinical cardiovascular disease, contributing to "unsuccessful aging." Frailty assessment tools vary, with the Fried scale and SPPB being commonly used. However, there is no consensus on the best tool, and different scales may be needed for different populations. Frailty is associated with increased risk of mortality, hospitalization, and adverse outcomes in various cardiovascular conditions, including heart failure, acute coronary syndromes, and cardiac surgery. Frailty assessment is important in pre-operative decision-making for cardiac surgery and TAVI, as it predicts post-operative outcomes and guides treatment. Frailty is also a key factor in TAVI, where it helps identify patients who may benefit from the procedure. Frailty assessment tools should be validated in the population of interest and adapted for different patient groups. Future research should focus on developing more robust frailty tools and biomarkers, as well as exploring interventions to improve frailty and outcomes in cardiovascular patients. Frailty assessment should be integrated into clinical practice to improve patient outcomes and guide care.Frailty is a biological syndrome characterized by decreased physiological reserve and vulnerability to stressors, and it has become a critical focus in cardiovascular medicine due to the aging and complex nature of patients. Over 20 frailty assessment tools have been developed, most focusing on core domains such as slow walking speed, weakness, inactivity, exhaustion, and shrinking. Prevalence of frailty ranges from 10% to 60%, depending on CVD burden and assessment tools. Frailty is associated with a relative risk of over 2 for mortality and morbidity in various cardiovascular conditions. It provides incremental prognostic insights and helps clinicians define optimal care pathways. Interventions like multidisciplinary cardiac rehabilitation are being tested to improve outcomes in frail patients. Frailty should not be seen as a reason to withhold care but as a means to deliver it more patient-centered. Frailty is linked to inflammatory biomarkers and subclinical cardiovascular disease, contributing to "unsuccessful aging." Frailty assessment tools vary, with the Fried scale and SPPB being commonly used. However, there is no consensus on the best tool, and different scales may be needed for different populations. Frailty is associated with increased risk of mortality, hospitalization, and adverse outcomes in various cardiovascular conditions, including heart failure, acute coronary syndromes, and cardiac surgery. Frailty assessment is important in pre-operative decision-making for cardiac surgery and TAVI, as it predicts post-operative outcomes and guides treatment. Frailty is also a key factor in TAVI, where it helps identify patients who may benefit from the procedure. Frailty assessment tools should be validated in the population of interest and adapted for different patient groups. Future research should focus on developing more robust frailty tools and biomarkers, as well as exploring interventions to improve frailty and outcomes in cardiovascular patients. Frailty assessment should be integrated into clinical practice to improve patient outcomes and guide care.