Key PointsQuestionIs there an association between frailty and outcomes following cardiopulmonary resuscitation for perioperative cardiac arrest?FindingsIn this cohort study of 3058 patients with perioperative cardiac arrests, frailty was associated with increased mortality and nonhome discharge. Among patients with severe frailty, increased Risk Analysis Index was associated with steadily increasing risk of mortality and nonhome discharge, and the association with mortality was most pronounced in the context of nonemergency surgery.MeaningIdentifying patients undergoing surgery with frailty may inform primary prevention strategies, guide shared decision-making regarding perioperative cardiopulmonary resuscitation, and promote goal-concordant surgical care.