Objective <p>To investigate the status of oral frailty in elderly patients with periodontitis in Anhui province and analyze the influencing factors.</p> Method <p>Clinical data of elderly patients with periodontitis admitted to the Department of Periodontology and Oral Medicine, Stomatological Hospital Affiliated to Anhui Medical University from January 2024 to December 2024 were retrospectively analyzed. According to whether oral frailty occurred, the patients were divided into the non-oral frailty group (<i>n</i> = 193) and oral frailty group (<i>n</i> = 1113). Binary Logistic regression analysis was used to explore the related factors that may affect oral frailty.</p> Results <p>The incidence of oral frailty in elderly patients with periodontitis was 85.2%. Binary Logistic regression analysis showed that smoking and drinking; periodontitis, with 1, 2, 3 or more chronic diseases, 16–20 natural teeth and &lt; 16 teeth, subjective masticatory difficulties, prefrail and frail were the risk factors for oral frailty in elderly patients with periodontitis (<i>P</i> &lt; 0.05). Moderate level and high level of oral health-related quality of life were protective factors for oral frailty in elderly patients with periodontitis (<i>P</i> &lt; 0.05).</p> Conclusion <p>Elderly patients with periodontitis demonstrating smoking habits, alcohol consumption, periodontitis, comorbidities, &lt; 20 natural teeth, subjective masticatory difficulties, frailty and poor oral health-related quality of life show elevated risks of oral frailty. This study identifies critical risk factors warranting clinical attention, though therapeutic interventions require further investigation through interventional studies.</p>