Aim: The Oral Frailty Diet (OF Diet) has been implemented since 2022 as a safe initial meal option for elderly patients on emergency admission, addressing risks of malnutrition,dysphagia, choking, and aspiration. However, the prevalence of oral frailty and dysphagia among elderly emergency admissions is unclear, and the suitability of the OF Diet against patients’ actual swallowing abilities has not been systematically assessed. Therefore, we aimed to evaluate the impact the OF Diet on swallowing function and dietary intake in elderly patients (≥70 years) on emergency admission. Methods: This retrospective study included 478 patients aged ≥70 years on emergency admission between October 2022 and December 2024. Patients were divided into OF Diet (n=108) and non-OF Diet (n=370) groups. Assessments included meal texture at admission and after modification, swallowing function (Seirei Swallowing Questionnaire), and dietary intake. Results: Initial meal provision comprised 53% regular diet and 23% OF Diet. The OF Diet group had a higher rate of suspected dysphagia on admission (p<0.0001). While the non-OF Diet group showed significant deterioration in meal texture from admission to modification (p<0.0001), the OF Diet group showed stable textures. A linear mixed model revealed significant main effects of the OF Diet (F=19.71, p<0.0001) on swallowing scores. The OF Diet group also demonstrated significantly lower dietary intake <30% (12.0% vs. 21.4%, p=0.0308). Conclusions: Implementation of the OF Diet enables safe initial meal provision for elderly patients on emergency admission who are at high risk of dysphagia, thereby improving dietary intake without negatively affecting swallowing function.