Abstract: With the aging of the population and improvements in medical services, the demand for surgical procedures among patients has been steadily increasing. However, while surgery helps control diseases, it also causes damage to the body. Elderly patients, due to reduced cardiopulmonary compensatory capacity, have significantly higher rates of perioperative complications and mortality. Prehabilitation is a process based on the principles of enhanced recovery after surgery （ERAS）, involving a series of measures implemented in the preoperative phase to enhance patients’ tolerance to upcoming physiological stress. These measures aim to strengthen functional reserves, optimize nutritional status, and improve psychological well-being, thereby reducing the incidence of postoperative complications and enhancing postoperative quality of life. This article reviews the current research progress on the application of prehabilitation strategies in elderly surgical patients, including the concept of prehabilitation, its current status, specific intervention measures, recommended application timing, challenges faced, and its application outcomes in elderly surgical patients. The aim is to provide clinical guidance for developing standardized prehabilitation intervention protocols for the elderly, with the goal of improving the prognosis of elderly surgical patients.