Objective To define the concept of fall alertness in the elderly and provide a reference for future research on this topic.Methods A systematic search was conducted in CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, and CINAHL to collect literature primarily focusing on fall alertness in the elderly. The search period was from the inception of the databases to October 2024, with language limited to Chinese and English. Included literature was screened based on inclusion criteria, and Rodgers′ evolutionary concept analysis was applied to analyze the literature.Results A total of 52 articles were included. Fall alertness in the elderly consisted of three attributes:subjective risk perception, behavioral intention to act, and fall situation.Antecedents contained external and internal factors.Consequent outcomes embraced low fall alertness leading to falls and related adverse health outcomes; higher fall alertness implies a higher awareness of fall risks and better adherence to fall prevention strategies.Conclusion Fall alertness in the elderly is defined as the subjective risk perception and behavioral execution intention characteristics of the el-derly towards existing or potential fall events based on the context in which they are located.Future research should further explore the connotations of fall alertness in the elderly in the context of China′s national conditions, and conduct in-depth research on rela-ted theories, assessment tools, influencing factors, and intervention measures to improve the sense of security and quality of life in the elderly.