Background: In elderly populations, postoperative complications and mortality have increased in tandem with an increase in orthopaedic surgery for problems like hip, knee, and spine deterioration. There are insufficient tools to predict postoperative outcomes in the elderly. Multidimensional frailty score (MFS) is one of the tools that have been used to predict postoperative mortality & morbidity. Objective: To measure postoperative morbidity and mortality in elderly patients with fragility fractures undergoing orthopaedic surgeries by using the Multidimensional Frailty Score. Methods: A prospective cohort study was conducted on 80 elderly (60 years or older) patients who were admitted to the orthopaedic department at Ain Shams University Hospitals from November 2022 to November 2023. They were presented with fragility fractures and were assessed before the surgical intervention by Multidimensional Frailty score (MFS) with cutoff point 5 (score ≤5: low risk & >5: High risk), then followed up for 3 months after the operation for postoperative complications, functional decline, nutritional state, delirium, pain, depression and death. Results: Our study showed that the MFS with A cut-off value of five (score ≤5: low risk &>5: High risk) has a good discriminatory ability to differentiate between patients who had postoperative complications and those who did not with sensitivity 78.79% and specificity 76.60%. However it has a poor ability to differentiate between patients who died and those who survived. Conclusion: The MFS demonstrated a good ability to predict the occurrence of postoperative complications, implying its potential value for preoperative assessment in elderly patients.