Meal preparation assessments conducted in clinical environments (such as rehabilitation settings) might not reflect frail patients' performance at home. In addition, factors that may explain differences in performance between settings remain unknown. The aim of this study was to compare home and clinic performance on meal preparation tasks in frail elders and to examine which factors may account for differences between settings. Thirty-three frail elders were assessed with the Performance Assessment of Self-Care Skills (heating soup, cutting fruit) in the home and clinic. A counterbalanced design was used. Factors related to the person (demographic, physical, cognitive, and psychological characteristics) and the environment were also collected. Participants overall showed significantly higher scores at home on heating a soup (F=4.125; P=0.015) and cutting a fruit (F=3.263; P=0.035). Better performance at home was associated with some demographic (lower education), cognitive (poorer executive functions), and environmental (higher similarity between settings) factors. Our findings may help health professionals clarify the profile of frail patients who should be assessed at home before discharge from rehabilitation and which features of the environment to consider when performing assessments in clinic settings. (Contains 1 figure and 4 tables.)