Introduction <p>Frailty, characterized by decreased resilience due to physiological decline, affects approximately 65% of community-dwelling elderly in Nepal. This study assessed frailty and its factors among hospitalized older adults in a tertiary hospital in Nepal.</p> Methods <p>This cross-sectional study included 124 participants aged 60 and above, admitted to a tertiary hospital in Nepal. Frailty was assessed using the Groningen Frailty Index (GFI), a validated self-reported tool. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with frailty, using STATA version 13.0.</p> Results <p>Frailty was observed in 58.8% of participants. Adjusted analysis showed that, compared to those who cannot read and write, those with no formal education had 0.14 times lower odds of frailty (<i>p</i> = 0.01, 95% CI 0.03–0.66), while those with formal education had 0.19 times lower odds (<i>p</i> = 0.01, 95% CI = 0.04–0.73). Participants with comorbidities had 3.51 times higher odds of frailty (<i>p</i> = 0.01, 95% CI: 1.22–10.07), and those with a history of falls had 8.10 times higher odds (<i>p</i> = 0.005, 95% CI: 1.89–34.78).</p> Conclusion <p>Frailty was prevalent in over half of the respondents. Lower levels of educational achievement, comorbidities, and a history of falls were identified factors of frailty. Targeted interventions addressing multimorbidity and fall prevention may reduce frailty risk among high-risk older adults in Nepal.</p>