Objective To investigate the status of SF and its influencing factors for the elderly in urban and rural areas in China, and to provide a reference for the development of relevant assessment and intervention measures.Methods From July 2023 to September 2024, a multi-stage stratified cluster random sampling method was used to select 1 826 elderly people from 9 communities in 13 rural areas of Xinjiang Uygur Autonomous Region as the research object. The general demographic characteristics, physiological health status, mental health status and social support status of the elderly were collected by questionnaire. The physical function status of the elderly was collected by physical measurement. Chi-square test, rank sum test and binary logistic regression were used to analyze the influencing factors of SF..Results A total of 1 826 valid questionnaires were collected, with an effective recovery rate of 94.2%. The overall prevalence of SF was 62.3%, with 76.0% in rural elderly and 45.0% in urban elderly. Binary logistic regression analysis showed that, Gender (female), education level (junior high school, primary school, no schooling), family monthly income (< 1000 yuan), depression (mild), nutritional status (nutritional risk, malnutrition) and physical activity (normal, mild limitation, severe limitation) were the influencing factors of SF in urban elderly (P < 0.05). Smoking (yes), economic source (other subsidies), swallowing function (abnormal) and comorbidity degree (high) were the influencing factors of SF in the rural elderly (P < 0.05).Conclusion The incidence of SF is high in the urban and rural elderly in Xinjiang, and the incidence of SF in rural elderly is higher than that in urban elderly, and the influencing factors of SF in urban and rural elderly are different. Medical staff should strengthen the screening and diagnosis of SF risk and health education for the elderly, and consider the urban-rural differences in the intervention of the elderly, so as to improve the quality of life and delay the occurrence and development of SF.