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Telehealth interventions improve health outcomes by increasing access to care. We conducted a systematic review to synthesize evidence on the effect of telehealth interventions compared with no intervention or usual care for older adults with pre-frailty or frailty for physical function, quality of life (QOL), and frailty. We searched for randomized controlled trials (RCTs) in MEDLINE, PubMed, Embase, CINAHL, Cochrane, PsycINFO, and SPORTDiscus. Two authors reviewed records and assessed risk of bias. A narrative synthesis of findings was conducted. When appropriate, the standard mean difference (SMD) was used to compare telehealth interventions with control conditions. We used GRADE to determine the certainty of the evidence. Twelve RCTs were included. Low certainty evidence highlighted positive effects for the function and mental component of QOL favoring telehealth interventions (SMD = 0.31, 95 …