Objective To develop a scale to measure health management needs of home-dwelling disabled elderly in rural areas, and to test its reliability and validity. Methods Based on the Problem Classification Scheme of the Omaha System, item pool of the scale was formed after literature review, then 18 experts were invited to participate in a two-round Delphi consultation. At last, 213 home-dwelling disabled older adults in rural areas of Henan Province were investigated to test the reliability and validity of the scale. Results Six factors with 29 items were extracted by exploratory factor analysis, including health records, physical assessment, mental health, medical environment, health knowledge and smart technology for elder-care, with a cumulative percentage of explained variance of 72.992%. The item-level content validity index （CVI） was between 0.889 and 1.000, and the scale-level CVI was 0.975. The Cronbach′s α coefficient was 0.897, the split-half reliability was 0.876, and the test-retest reliability was 0.902. Conclusion The health needs assessment for rural home-dwelling disabled elderly has good reliability and validity, which can be used as an effective tool to evaluate health management needs of home-dwelling disabled older people in rural areas.