Purpose <p>Cancer-related financial toxicity (FT) plays a key role in patients’ disease prognosis, well-being, and quality of life. This study aimed to explore the experiences and coping strategies related to FT among frail older colorectal cancer (CRC) survivors in China.</p> Methods <p>This study adopted a descriptive qualitative approach. Individual interviews were performed with 10 frail older CRC patients at a local hospital from March 2024 to August 2024. Relevant data were analyzed using the Colaizzi’s phenomenological analysis.</p> Results <p>The experiences of FT among frail older CRC patients included (1) insufficient economic income and inadequate medical security; (2) long course of cancer treatment and unaffordability of financial burden; (3) the vulnerability of household economies; and (4) under high psychological pressure and a sense of financial uncertainty. Meanwhile, the coping strategies to mitigate the impacts of FT in this population were as follows: (1) utilizing medical security and insurance policies to reduce FT; (2) financial planning, support, and sharing of responsibilities among family members; and (3) self-psychological adjustment and family members’ emotional support.</p> Conclusion <p>Mitigating FT in frail older CRC survivors is crucial for improving their disease outcomes and quality of life. Understanding the experiences related to FT and identifying relevant coping strategies in this population may contribute to formulating medical and health policies for protecting these patients and their families from the adverse effects of FT. Future studies should be placed on developing effective interventions and providing personalized support for this population to alleviate FT.</p>