Background <p>Housebound older adults residing in relatively isolated living environments for extended periods encounter a range of health and psychological challenges, stemming from limited mobility spaces and diminished social engagements. The fear of falling, a prevalent psychological issue among this demographic, is intricately linked not only to the actual risk of falling but also exerts a profound influence on their behavioral patterns and quality of life. This study aims to understand the current situation of fear of falling, i.e., FOF, among the Housebound older adults and analyze its influencing factors to provide a reference for formulating targeted nursing interventions. </p> Methods <p>A cross-sectional survey was conducted from February to April 2025. FOF scores of 229 Housebound older adults individuals were estimated by analyzing their responses to a general questionnaire and the Fear of Falling Questionnaire-Reversed (FFQ-R). </p> Results <p>Participants’ total FOF score was estimated as (41.90±9.95), representing a medium-to-high level of fear of falling. The results of univariate analysis indicated statistically significant difference in the FOF scores of the participants with different characteristics, namely, gender, marital status, education level, smoking history, drinking history, chronic disease history, living style, and fall history (<i>P</i>&lt; 0.05). The results of multiple linear regression analysis suggested that gender, smoking history, chronic disease history, living style, and fall history were independent factors affecting fear of falling among the Housebound older adults. </p> Conclusion <p>Based on our results, we recommend that community nurses should pay special attention to Housebound older adults, especially those who are female, live alone, or have a history of smoking, chronic disease, or falls and implement targeted nursing interventions to allay fear of falling among the Housebound older adults.</p>