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Introduction Malnutrition is highly prevalent among older adults hospitalized in the acute geriatric ward at Fann University Hospital, Dakar, Senegal. However, data on the prevalence and risk factors of malnutrition in hospitalized older patients in sub-Saharan Africa are limited. The aim of this study was to assess the prevalence of malnutrition and identify its risk factors in older adults admitted to the acute geriatric ward at Fann University Hospital in Dakar, Senegal. Methods A retrospective analytical study was conducted on 375 patients aged 60 and over, admitted to the acute geriatric ward between January 2021 and December 2022. Data on sociodemographic characteristics, medical history, geriatric syndromes, and nutritional status were collected from medical records. Malnutrition was assessed using the Mini Nutritional Assessment (MNA). A bivariate analysis was performed to explore the association between malnutrition and potential risk factors. Results The prevalence of malnutrition was 72% (n = 270). Malnutrition was significantly associated with female sex (p = 0.019), presence of multiple comorbidities (p < 0.001), functional dependence (p = 0.007), immobilization syndrome (p = 0.016), and pressure ulcers (p = 0.016). Conclusion Malnutrition is highly prevalent among older adults hospitalized in the acute geriatric ward at Fann University Hospital, Dakar, Senegal. This study identified several factors significantly associated with malnutrition, highlighting the need for increased awareness and targeted interventions to address this important geriatric syndrome.