Objective To construct an evidence-based preoperative nutritional management program for elderly patients with digestive tumors complicated with frailty, and to preliminary apply and explore the implementation effect of the program. Methods The preoperative nutritional management program for elderly patients with digestive tumors complicated with frailty was formulated through systematic literature retrieval and expert consultation. A total of 90 elderly patients with digestive tumors complicated with frailty who were scheduled for operation were divided into a control group (n=45) and an experimental group (n=45) according to the admission time. The control group was given routine nutritional nursing, while the experimental group was subjected to the preoperative nutritional management program for elderly patients with digestive tumors complicated with frailty. The BMI and serum biochemical indicators of the two groups were collected before intervention, one day prior to surgery and before discharge. The Patient-Generated Subjective Global Assessment (PG-SGA) and Edmonton Frail Scale (EFS) were also used for evaluation. Results The preoperative nutrition management plan for elderly patients with digestive tumors complicated with frailty included 4 first-level items, 17 second-level items and 56 third-level items. A total of 43 patients in the control group and 45 patients in the observation group completed the study. The BMI, serum biochemical indicators, PG-SGA score, and EFS score of the experimental group were significantly better than those of the control group (all P<0.05). Conclusion The nutritional management program for elderly patients with digestive tumors complicated with frailty constructed in this study has good scientificity and practicability, and it can help to improve nutritional status of patients.