Objective To develop and test the reliability and validity of the screening tool for palliative care in the intensive care unit, aiming to provide a convenient and effective screening tool for ICU medical staff. Methods Literature review and Delphi expert consultation were performed to develop the screening tool, then 206 ICU patients were retrospectively analyzed to test the reliability and validity of the tool.The value for triggering palliative are was determined. Results The screening tool for palliative care in the intensive care unit included 3 primary-level indicators and 17 secondary-level items. The content validity index of the total scale was 0.919, and the inter-rater reliability was 0.979.Patients transferred out of the ICU had significantly lower screening score than those died in the ICU (P＜0.05).The score for triggering palliative care was 8.5 points, with the area under the receiver operating characteristic curve of 0.992 ［95%CI（0.983, 1.000）, P＜0.05］, the sensitivity of 0.936, the specificity of 0.969, the positive predictive value of 0.917, and the negative predictive value of 0.981. Conclusion The screening tool for palliative care in the intensive care unit has good reliability and validity,which can be used to identify patients with palliative care needs in the intensive care unit.