Purpose <p>This study aimed to develop and validate a Chinese version of the Frailty Risk Perception Questionnaire (FRPQ) for older adults with colorectal cancer.</p> Methods <p>The study was conducted in two phases. In phase 1, a preliminary questionnaire was developed based on theoretical framework analysis, literature review, and qualitative interviews conducted in Chinese with 25 older adults with colorectal cancer. In phase 2, the reliability and validity of the Chinese FRPQ were evaluated through a cross-sectional survey of 350 older adults with colorectal cancer aged 65–85&#xa0;years across different treatment stages.</p> Results <p>Exploratory factor analysis identified a four-factor structure explaining 63.25% of the total variance: perceived susceptibility (17 items), perceived severity (8 items), cognitive risk (5 items), and emotional risk (6 items). The Chinese FRPQ demonstrated good construct validity, with satisfactory convergent validity (correlation coefficients with Fried Frailty Scale: r = 0.683, <i>p</i> &lt; 0.001; with TFI: r = 0.715, <i>p</i> &lt; 0.001) and known-group validity (significant differences among robust, pre-frail, and frail groups, <i>p</i> &lt; 0.001). The Cronbach's alpha coefficient for the total scale was 0.942, with subscale coefficients ranging from 0.867 to 0.923. Test–retest reliability over two weeks showed an intraclass correlation coefficient of 0.875.</p> Conclusion <p>The 33-item FRPQ is a valid and reliable instrument for assessing frailty risk perception among older adults with colorectal cancer. This tool may help healthcare providers better understand patients' perceptions of frailty risk and develop targeted interventions.</p>