Abstract: Hypertension and frailty are both highly prevalent conditions in the elderly population. They often coexist and mutually exacerbate each other, posing a joint threat to the health and quality of life of older adults. Current mainstream medical consensus holds that frailty assessment must be conducted before initiating antihypertensive therapy in elderly hypertensive patients. However, there is no standardized protocol for the pharmacotherapy of hypertension combined with frailty in the elderly. The core principles are individualized treatment goals and personalized medication strategies. The impact of various antihypertensive drugs on frailty remains controversial, and the efficacy and safety of other drug classes are still under investigation. Traditional chinese medicine treatment may serve as a breakthrough to address the therapeutic bottlenecks in this field.