Objective To evaluate the correlation between potential inappropriate medications (PIM) and adverse outcomes in frail elderly. Methods A total of 226 elderly suffering from senile debility in Fuxing Hospital from January 2015 to December 2017 were recruited, and then divided into PIM group (n=169) and non-PIM group (n=57) according to Beers Standard of American Geriatrics Association (2015 edition). Their daily living ability (ADL), cognitive function and Charlson comorbidity index (CCI) were compared between the 2 groups. All patients were followed up till December 2018, and unplanned readmission and all-cause death were regarded as the end-points of adverse outcomes. SPSS statistics 23.0 was used for data analysis. Cox regression analysis was employed to analyze the correlation between PIM and adverse outcomes in the frail patients, and Kaplan-Meier survival analysis was applied to analyze the differences in survival rates between the 2 groups. Results The detection rate of PIM was 74.8%(169/226). Rabeprazole accounted for 52.7%(89/169) and Estazolam for 42.6%(72/169) among all PIM drugs. Compared with non-PIM group, the types of oral drugs and the number of diseases were significantly larger in PIM group (P<0.05). Cox regression analysis showed that PIM (HR=1.425, 95%CI 1.005-2.021; P=0.047), age (HR=1.047,5%CI 1.013-1.083; P=0.007) and CCI (HR=1.095, 95%CI 1.014-1.182; P=0.021) were associated with adverse outcomes. Kaplan-Meier analysis showed that there was significant difference in survival rate between PIM group and non-PIM group (P=0.033). Conclusion PIM is related to the adverse outcomes of patients with senile debility. We should strengthen the screening of senile debility and rational drug use in clinical practice.