Objective To systematically evaluate the impact of preoperative frailty on adverse health outcomes in liver transplant recipients.Methods Chinese and English databases were searched, in order to collect cross-sectional studies, cohort studies, or case-control studies on preoperative debility and adverse health outcomes in liver transplant recipients, the search period was form the establishment of the database up to January 2024.Two researchers independently screened the literatures, extracted the data, and assessed the quality of studies.Descriptive analysis was used to integrate and analyze the results.Results A total of 14 studies were included, including 12 cohort studies and 2 cross-sectional studies, with a total of 6,012 study participants.The results of the descriptive analysis showed that preoperative frailty in liver transplant recipients can lead to an increased risk of death, prolonged hospitalization, increased postoperative complications, and decreased quality of life.Conclusion The preoperative frailty in liver transplant recipients is closely associated with multiple adverse health outcomes.Medical staff should pay more attention to the preoperative frailty in liver transplant recipients and take early interventions in order to prevent or delay the occurrence of frailty and improve the health outcomes of liver transplant recipients.