Background <p>Community pharmacists are expected to contribute to frailty prevention through physical activity and exercise support. However, their definitive involvement and the factors influencing their engagement remain unclear.</p> Methods <p>An anonymous online questionnaire-based survey targeting pharmacists working in community pharmacies or the pharmacy sections of drugstores was conducted from November 2024 to March 2025. The survey assessed their recognition, attitudes, and practices regarding frailty and support for physical activity and exercise. Frailty assessment was defined as responses of “occasionally” or more. Descriptive statistics and multivariate logistic regression were used for the analysis.</p> Results <p>Among the 1,054 responses, 89.8% expressed positive attitudes toward supporting physical activity and exercise, but insufficient knowledge and lack of confidence were major barriers. Furthermore, although 88.3% of respondents considered awareness of the patient frailty status to be important and 60.1% recognized the importance of pharmacist-led frailty assessments, only 29.6% performed such assessments. The independent factors associated with frailty assessment were implementation of pharmacist-led support for physical activity and exercise (adjusted odds ratio [aOR]: 2.46; 95% confidence interval [CI]: 1.73–3.50), recognition of the importance of frailty assessment (aOR: 2.83; 95% CI: 1.97–4.07), and availability of educational opportunities related to physical activity and exercise support (aOR: 1.62; 95% CI: 1.12–2.34).</p> Conclusion <p>While many pharmacists recognize the importance of frailty care, their involvement remains limited due to insufficient knowledge. Practical and educational experiences regarding physical activity and exercise support were significantly associated with frailty assessment practices, suggesting their importance in promoting future pharmacists’ engagement in frailty prevention.</p>