Aim: To synthesize relevant literature specific to disaster vulnerability of elderly and medically frail individuals in the USA and investigate the role of the public health nurse in mitigating the problem. Methods: Focused review of the literature, including peer-reviewed research, journal articles, news articles, education materials and reports from governmental and senior advocacy groups. Results: Disaster vulnerability of the elderly and the medically frail is related to sociodemographic factors such as advanced age, low socioeconomic status, female gender, low education and language barriers. The presence of chronic illnesses, deficits in mobility, cognitive, and sensory capacity, reliance on others and devices, lack of social support, and previous experience with disaster also contribute to their vulnerability. Conclusions: The elderly and the medically frail are highly vulnerable to the negative consequences of disaster. Implications for public health nursing practice before, during and after disaster, as well as nursing research, are highlighted.