Objective To establish a competence evaluation system for anesthesia specialist nurses in China, and to provide reference for the training and evaluation of anesthesia specialist nurses. Methods The indexes and weights of the competence evaluation system for anesthesia specialist nurses were determined through literature review, group discussion, Delphi expert consultation and analytic hierarchy process method. Results The competence evaluation index system for anesthesia specialist nurses included 5 first-level indicators (professional knowledge, professional expertise, professional ability, management ability and personal characteristics) and 38 second-level indicators. The response rates for the two-rounds of expert consultation were 89.47% and 94.12%, the authoritative coefficients were 0.865 and 0.889, and the Kendall coordination coefficients were 0.182 and 0.237, respectively （all P＜0.01）. Conclusion The competence evaluation system for anesthesia specialist nurses, can be used as a tool to evaluate the competency level of anesthesia specialist nurses, and provide references for training, assessment and appointment of anesthesia specialist nurses.