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The purpose of this review was to determine the association between frailty and mortality among adults ≥ 65years old undergoing emergency general surgery (EGS). This systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews was conducted from inception to March 5, 2020. Studies with patients ≥ 65years undergoing EGS were included. The primary exposure was frailty, measured using the Clinical Frailty Scale or t