Non-traumatic major lower limb (LL) amputation is a devastating complication associated with diabetes and peripheral arterial disease, carrying a high risk of perioperative adverse events and mortality. Previous studies investigated the impact of comorbidities on postoperative outcomes in patients who undergo non-traumatic major LL amputation, highlighting their heightened risk of 30-day mortality and prolonged inpatient stays. However, there remains a lack of research examining inpatient adverse events such as pressure injury, falls, delirium and incontinence. This study aimed to describe the association between pre-operative frailty status and the risk of hospital-acquired complications (HAC) and hospital-acquired infections (HAI). Retrospective study of adult patients admitted to the tertiary centre who underwent non-traumatic major LL amputation between January 2010 to December 2023. All data were extracted from the Admitted Patient Data Collection. Frailty status on admission was estimated using a cumulative deficit approach. During the study period, 642 adults with an average age of 65.5 years (1-SD = 13.2) underwent LL amputation. 40% (n= 254) had 4 or more deficits, and 23% (n = 145) had no deficits at the time of admission. The risk of any HAC increased with the no. of frailty deficit items (4+ items 252/254 99.2%, versus 0-items, 116/145, 80%). A similar association was seen with HAI (4+ items: 33/254, 12.9%, versus 0 items: 9/145, 6.2%). The most common HAC was at least one hospital fall (n = 54), followed by delirium (n = 47). The most common HAI was surgical site infection, followed by acute pneumonia. Among this group undergoing LL amputation, frailty status at the time of hospital admission was observed to be a significant risk factor for hospital adverse events, like HACs and HAI. These results support the need for targeted models of care for frail older adults in the surgical setting.