Objective To construct an evaluation index system for age-friendly livability in elderly care institutions, thereby providing a tool for assessing the age-friendly livability of such institutions. Methods The index database was established based on literature retrieval, and the DPSIR model was used to extract and sort the initial index system.Two rounds of expert consultations were conducted using the Delphi method to determine the indicators, and the Precedence Chart method （PC）, the G1 method, and the Decision Experiment Laboratory （DEMATEL）method were used to determine each indicator′s weigh. Results The expert positive coefficients of the two rounds of consultations were 90.91% and 90.00%, while the expert authority coefficients were 0.72 and 0.72, and the coordination coefficients were 0.112 and 0.298 (all P＜0.05). The established index system comprised 9 first-level indicators and 36 second-level indicators, including community level, community facilities, subjective attributes of the elderly, interpersonal relationships of the elderly, community services, community activities, psychological state of the elderly, attitudes toward aging, and institutional policies. Conclusion The established evaluation indicator system comprehensively considers both the objective environment of the elderly care institutions and the subjective feelings of the elderly themselves.This system can be used to evaluate whether elderly care institutions and other community-based organizations are age-friendly and livable, so as to establish high-quality elderly care institutions that promote social interaction and participation in community activities for the elderly.