Purpose <p>Oral frailty screening and care for elderly cancer patients undergoing chemotherapy have yet to be integrated into cancer care protocols, and there persists a notable deficiency in knowledge concerning the experiences of elderly cancer patients suffering from oral frailty. This study aims to explore the experiences and responses of elderly Chinese cancer patients undergoing chemotherapy for oral frailty.</p> Methods <p>Beginning in February 2024, a purposive sampling approach was used to select elderly cancer patients undergoing chemotherapy who scored four or higher on the Oral Frailty Index-8 scale for semi-structured interviews. Two researchers analyzed the data using interpretive phenomenological research methods.</p> Results <p>Twenty-five elderly cancer patients undergoing chemotherapy with oral frailty were recruited. Four themes were identified: (1) The eroded mouth, impairment and decline; (2) confronting a failing body, at a loss and exhausted; (3) navigating uncertainty, helplessness and struggles; and (4) finding a new balance, transcendence and personal growth. Among these four themes, the researchers developed 13 subthemes.</p> Conclusion <p>The experiences and coping processes of oral frailty in elderly cancer patients undergoing chemotherapy are complex, encompassing both positive and negative physical and psychological experiences. Oncology nurses must emphasize the oral health of elderly cancer patients undergoing chemotherapy and integrate oral frailty screening and care throughout the entire cancer treatment process.</p>