We evaluated prevalence of MN risk, dietitian documented MN (DDMN), physician coded malnutrition (PCMN) in consecutive inpatients with solid tumors. EMR reviewed for admissions (2016–2019). High MN risk (≥2 on Malnutrition Screening Tool; MST) completed by an RN at admission. Dietitian notes examined DDMN/grade. PCMN based on discharge codes. Multivariate logistic regression models identified associations between clinicodemographic factors and MN prevalence. N=5143; 48% females. Median age 63 (range 18–102) years. 70% White; 24% Black. Common cancers: digestive system 25%, thoracic 19%. MST completed in 79%. Among those with MST≥2 (N=1,005), DDMN/PCMN prevalence 30% and 22%, respectively. In entire cohort, 8% DDMN; 7% PCMN; 4% both. DDMN mild 2%; moderate 16%; severe 66%. PCMN mild 10%; moderate 0%; severe 69%. Male gender (OR 1.3), Black race (OR 1.6), stage IV disease (v I–III) (OR 3.1), primary site independent predictors of DDMN; Black race (OR 1.5), stage IV disease (OR 2.7), primary site independent predictors of PCMN (p<0.05). 25% were at high risk for MN. Primary site, disease stage, race independent predictors of greater risk. MN appeared to be underdiagnosed.