Objective To evaluate the effect of applying Delphi- based workload performance appraisal in Pediatric Intensive Care Unit （PICU） under vertical management mode. Methods According to the results of literature search and interviews, a table of PICU nursing workload was compiled by Delphi method.Then workload based nursing performance salary distribution in PICU was implemented. Before and after the implementation of workload based nursing performance salary distribution, PICU nurses′ work enthusiasm, nursing quality score, nurses′ job satisfaction were compared. Results After 2 rounds of expert consultation, PICU nur-sing workload table consists of 7 first-level indicators(daily orders and medicine, management of the unit, daily severity of PICU children, patient admission and discharge, fundamental nursing procedures, critical care nursing procedures, and specialized care), and 62 secondary indicators. After the implementation of workload based PICU nursing performance salary distribution, nurses′ work enthusiasm, nursing quality scores and job satisfaction were higher than before the implementation （P＜0.05,P＜0.01）. Conclusion The implementation of workload-based PICU nursing performance salary distribution can ensure the fairness and transparency of nursing performance salary distribution, and achieve the goal of more work, better performance and better pay.