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Older people have a high incidence of adverse outcomes after urgent care presentation. Identifying high-risk older patients early is key to targeting interventions at those patients most likely to benefit. This study used the Frailsafe three-point screening questions amongst older Emergency Department (ED) attendees. Consecutive unplanned ED attendances in patients aged &#8805;75 were assessed for Frailsafe status. The primary outcome was mortality at 180 days. A Frailsafe screen was completed in 356 patients, of whom 194/356 (54.5%) were Frailsafe positive. The mean age was 85.8 for Frailsafe screen positive and 82.2 for Frailsafe screen negative patients (<i>p</i> &lt; 0.001). A positive Frailsafe screen was a predictor of death within 180 days of presentation to the ED and remained so after adjustment (AOR = 3.23, 95% CI 1.45&#8722;7.19, <i>p</i> = 0.004). A positive Frailsafe screen was an independent predictor of a new care home admission at 180 days (AOR = 8.95, 95% CI 2.01&#8722;39.83, <i>p</i> = 0.004). A positive Frailsafe screen was also predictive of a number of secondary outcomes, such as length of stay of &gt;28 days (AOR 3.42, 95% CI 1.41&#8722;8.31, <i>p</i> = 0.007) and re-attendance within 30 days of discharge after admission (OR = 2.73, 95% CI 1.27&#8722;5.88, <i>p</i> = 0.01). Frailsafe screen results independently predict a range of outcomes amongst older ED attendees.