Objective To develop a diet self-management questionnaire for hemodialysis patients, and to provide a scientific and effective evaluation tool for clinical dietary guidance and nursing intervention. Methods By conducting literature review and interviews, and referencing to textbooks, monographs and clinical guidelines for chronic kidney disease and dialysis, a pool of questionnaire items concerning diet self-management for hemodialysis patients were developed.Then the items were subjected to expert review, and pre-survey to form an initial questionnaire, which then went through a pilot test, and subsequently a large sample test. After item selection, and validation of reliability and validity, the Diet Self-management Questionnaire for Hemodialysis Patients was finalized. Results The final version of the questionnaire consisted of five dimensions (diet knowledge, diet attitudes and confidence, sticking to dietary principles, diet control and adjustment, communication with medical staff regarding diet), totaling 24 items. The overall Cronbach′s α coefficient was 0.856 for the questionnaire, and 0.674-0.879 for the dimensions. The content validity index was 0.935,and the test-retest reliability coefficient was 0.940. Five common factors were extracted through exploratory factor analysis, and the overall cumulative variance contribution rate of the questionnaire was 60.946%. The results of confirmatory factor analysis showed that χ2/df was 1.051 and RMSEA was 0.051, which indicated good model fit. Conclusion The Diet Self-management Questionnaire for Hemodialysis Patients has good reliability and validity, and can be used as an evaluation tool in clinical practice.