Objective To develop a Risk Assessment Scale for Intraoperative Hypothermia in Infants and Young Children, so as to enable healthcare professionals to accurately identify, quantify, and stratify such risk during surgical procedures. Methods A preliminary draft of the scale was developed by identifying and synthesizing risk factors for intraoperative hypothermia in infants and young children through literature review and group discussions,then it was refined using the Delphi method and a pre-survey, finally, 437 pediatric surgical patients were enrolled via convenience sampling and assessed to test its reliability and validity. Results The final Risk Assessment Scale for Intraoperative Hypothermia in Infants and Young Children consisted of two first-level indicators, twelve second-level indicators, and 35 third-level indicators. Its Cronbach′s α coefficient was 0.852, its split-half reliability was 0.709, and inter-rater reliability was 0.972. Its cutoff value was 25 points, with a sensitivity of 0.860 and a specificity of 0.837. Total scores of 25-26 points indicated low risk, 27-28 points demonstrated moderate risk, and ≥29 points showed high risk. Conclusion The Risk Assessment Scale for Intraoperative Hypothermia in Infants and Young Children has good reliability and validity, supporting its utility in assessing intraoperative hypothermia risk.