ABSTRACT Objective Patient frailty negatively impacts postsurgical outcomes across multiple specialties. Commonly used frailty scoring systems include the Modified 5‐Item Frailty Index (MFI‐5) and the Clinical Risk Analysis Index (RAI‐C). We compared these frailty indices in predicting postsurgical outcomes in otolaryngology, a comparison that has never been completed to date. Methods Retrospective chart review of patients undergoing otolaryngologic surgery at a quaternary care medical center (2022–2024) with an RAI‐C score available for analysis. Chi‐square analysis and ROC curves were utilized to determine associations and predictive ability of each scoring system. Results Among 1209 patients, 21% met MFI‐5 frailty criteria (MFI‐5 score > 1), and 23% met RAI‐C frailty criteria (RAI‐C score > 30). The Pearson correlation coefficient between MFI‐5 and RAI‐C was 0.481 (95% CI [0.43, 0.53]), indicating a moderate correlation between the two metrics. Patients deemed frail by RAI‐C had 5.7 times higher odds of experiencing a postoperative complication than non‐frail counterparts (95% CI [3.51, 9.28], p < 0.0001), but MFI‐5 frailty status was not associated with postoperative complications. Both RAI‐C and MFI‐5 demonstrated significant predictive ability for 30‐day readmission (AUC 0.77, 95% CI [0.64, 0.89] vs. AUC 0.76, 95% CI [0.61, 0.88]), respectively. When compared to MFI‐5, RAI‐C had greater predictive performance for all other postoperative outcomes in this study. Conclusion RAI‐C outperformed MFI‐5 in predicting postoperative outcomes in patients undergoing otolaryngologic surgeries. RAI‐C assessment should be considered in frailty research, multidisciplinary treatment planning, and managing patient expectations and outcomes.