Abstract Objective To evaluate the current status of physical activity and its influencing factors among pre-frail rural empty-nest older adults, and to provide targeted recommendations for improving the quality of life for rural empty-nest older adults. Methods A purposive sampling method, considering convenience, was used to select participants. Between May and December 2023, a questionnaire survey was conducted among pre-frail rural empty-nest older adults in Chaoyang County, Liaoning Province. The survey included a demographic information form, a lifestyle behavior questionnaire, a nutrition risk assessment scale, and a physical activity scale for the older adults. Results A total of 522 pre-frail older adults were included in this study. The median score for physical activity was 162.5 (109.0, 229.0), with walking (98.5%) and household physical activities (85.8%) being the predominant forms of activity. Logistic regression analysis revealed that the presence of hypertension (OR = 1.537), coronary heart disease (OR = 1.490), respiratory diseases (OR = 1.534), osteoarthritis (OR = 1.726), and malnutrition (OR = 1.637) were independent risk factors for low physical activity levels in pre-frail rural empty-nest older adults (P