Pressure ulcer is one of the most common, disruptive and often disabling conditions affecting frail older people. Purposes of the present study are to ascertain the prevalence of pressure ulcer and to explore the relationship between pressure ulcer and the risk of 1-year all-cause mortality in a large population of frail and very old people living in community. This was an observational cohort study. We analyzed data from the Italian Silver Network Home Care project that collected data on patients admitted to home care programs. A total of twelve home health agencies participated in such project evaluating the implementation of the minimum data set for home care (MDS-HC) instrument. A total of 3,103 patients were enrolled in the present study. The prevalence of patients with pressure ulcer was about 18%. During a follow-up of 12 months from the initial MDS-HC assessment, 160 subjects (29%) died in the pressure ulcer group compared to 368 subjects (14%) in the group of patient without pressure ulcer (p<0.001). After adjusting for age, gender and for all the significantly different variables between subjects with and without pressure ulcer at baseline, subjects with pressure ulcer were more likely to die compared to those without pressure ulcer (RR=1.92; 95% Cl 1.52-2.43).