Objective To develop an index system for home environmental risk assessment for the elderly. Methods Literature review, focus group discussion and Delphi expert consultation were utilized to develop the indicators, then analytic hierarchy process was performed to determine weight of the indicator. Results The return rate of questionnaires was 92.31% in round 1 and 86.11% in round 2 of expert consultation. The authority coefficients of two rounds were 0.878 and 0.892, respectively. The coordination coefficients of the first-level indicators were 0.276 and 0.291, respectively. The final index system consisted of 9 first-level indicators and 43 second-level indicators, and weights of the indicators were identified. Conclusion The home environmental risk assessment index system for the elderly achieved a good level of consensus, which has comprehensive contents and reasonable weights. However, it should be validated in community.