Objective To investigate the impact of individualized exercise intervention on the improvement of frailty and physical function in elderly inpatients. Methods Fifty-eight elderly patients (FRAIL score ≥1) admitted in the Zhongnan Hospital from August 2018 to February 2019 were recruited in this study. They were randomly divided into control and experimental group, with 29 cases in each. The control group received only routine nursing care and routine education during hospitalization. On the basis of these, the experimental group was given multi-component individualized exercise, including muscle strength training, aerobic training and balance training. After 12 weeks′ intervention, the frailty status, walking speed, and result of time up and go test (TUGT) were recorded and compared between the 2 groups. SPSS statistics 18.0 were used for data analysis. Results Before intervention, there was no significant difference in the composition ratio of frailty severity between the 2 groups (experimental group:16 cases in pre-frailty, 13 in frailty; control group:12 in pre-frailty and 17 in frailty; P=0.293), but after 12 weeks of intervention, obvious difference was seen in the composition ratio (experimental group:20 in the pre-frailty, 9 in frailty; control group:8 in pre-frailty and 21 frailty; P=0.002). There was notable difference in the composition ratio in the experimental group before and after the intervention (P=0.019), but no such difference was seen in control group (P=0.269). Before intervention, there were no significant differences in walking speed [(0.61±0.16) vs (0.59±0.14)m/s] and TUGT [(17.82±3.48) vs (18.25±3.32)s] between the 2 groups (P>0.05). After 12 weeks of intervention, the experimental group had remarkably better walking speed [(0.66±0.12) vs (0.57±0.11)m/s] and improved TUGT [(16.19±2.74) vs (19.84±2.35)s] than the control group (P<0.05). There were also significant differences in walking speed and TUGT in experimental group before and after treatment, so were the TUGT in control group (P<0.05). Conclusion Multi-component individualized exercise intervention can improve the frailty status and physical function in frail elderly inpatients, and is worthy of clinical promotion.