Objective To systematically retrieve, extract, summarize and analyze the best evidence for exercise rehabilitation management in elderly patients with coexisting coronary heart disease and frailty, thereby providing a reference for exercise decision-making and intervention in this population. Methods Following the "6S" evidence pyramid model, all evidence on exercise interventions for older patients with coexisting coronary heart disease and frailty was searched from top to bottom in a sequential manner from relevant national and international databases, including clinical practice guidelines, evidence summaries, clinical decision-making, expert consensus, and systematic evaluations. Literature screening and quality evaluation were conducted independently by two researchers, and relevant evidence was extracted and summarized according to themes. Results A total of 16 publications were included, comprising 6 guidelines, 4 expert consensus, 1 evidence summary, 4 systematic reviews, and 1 clinical decision-making.29 pieces of best evidence were summarized into 8 themes, including multidisciplinary team, exercise assessment, exercise flow, exercise intensity, exercise mode, exercise frequency and duration, exercise safety, and follow-up. Conclusion Medical staff should consider the actual clinical situation and specific needs to select the best evidence for exercise rehabilitation in elderly patients with coexisting coronary heart disease and frailty, so as to slow down or reverse frailty and improve patients′ quality of life.