Falls are the important causes of morbidity and mortality in older adults. Although clinical staff have paid attention to the management of falls, adherence to fall interventions is not satisfactory, resulting in the high incidence of fall. Understanding the older adults' own perception of fall risk from their perspective may be the key to fall prevention, especially active fall prevention. In this paper, we reviewed the concept of fall risk perception, behavioral consequences and influencing factors of fall risk perception in older adults from the perspective of "the first person responsible for health", and found that there are fewer studies on fall risk perception in older adults at home and abroad, the conceptual connotation still needs to be further explored. Subjective perceptions of fall risk in older adults can lead to different patterns of fall risk coping behaviors that influence fall risk. The influencing factors of fall risk perception mainly focus on the emotional psychology, physiological conditions, social culture, and physical environment, with the influencing process through subjective cognition. Empirical studies can be used to further validate the psychological cognitive mechanisms of fall risk perception in conjunction with the risk perception formation process in the future, in order to provide empirical evidence for proactive fall prevention.