Objective To develop a risk assessment scale for peristomal moisture-associated skin damage, in order to provide a clinical tool for assessing the risk of such damage. Methods On the basis of literature analysis, the related risk factors of peristomal moisture-associated skin damage were compiled to form an initial item pool.Through expert meeting method and two rounds of Delphi expert letter consultation, the index system was revised to form the risk assessment scale of peristomal moisture-associated skin damage.The reliability and validity of the evaluation scale were tested in 118 patients who underwent enterostomy operations in the department of general surgery. Results The formal scale consisted of 4 first-level indicators, 11 second-level indicators and 21 third-level indicators.The average content validity index (S-CVI/ave) at scale level was 0.956, and the content validity index (I-CVI) at item level was 0.914~1.000.Among 118 patients undergoing enterostomy, 42(35.59%) had peristomal moisture-associated skin damage.The predictive validity area under ROC curve (AUC) of the scale was 0.865 (P＜0.001).When the critical value of the scale was 14.5, the Youden index was 0.525, the sensitivity was 0.643, and the specificity was 0.882.The total Krippendorff′s α coefficient of the scale was 0.794, and the Krippendorff′s α coefficient of the first-level indicators were 0.651~0.779. Conclusion The constructed risk assessment scale for peristomal moisture-associated skin damage demonstrates good reliability and validity, which provides an effective assessment tool for clinical nursing staff to identify high-risk patients early and reduce skin damage in patients with enterostomy.