Objective To develop a Nutrition Literacy Scale for Elderly Patients with COPD and test its reliability, to provide a basis for accurately assessing the patients′ nutrition literacy level and carrying out personalized nutrition literacy interventions. Methods Based on the Health Literacy Stratification Model, a pilot version of the Nutritional Literacy Scale for Elderly Patientswith COPD was constructed by combining literature analysis, Delphi expert consultation, and pre-investigation. A total of 439 patients were included to test the reliability and validity of the scale. Results The Nutrition Literacy Scale for Elderly Patients with COPD included 3 dimensions and 30 items. A total of 6 common factors were extracted by exploratory factor analysis, which explained 70.658% of the total variation. Confirmatory factor analysisshowed that χ2/df=2.977, IFI=0.882, CFI=0.881, NFI=0.832, TLI=0.869, RMR=0.063, and RMSEA=0.092.The S-CVI/Ave was 0.926, and the I-CVI ranged from 0.778 to 1.000. The Cronbach′s α coefficient of the overall scale was 0.943, the split-half reliability Spearman-Brown was 0.849, and the test-retest reliability was 0.927. Conclusion The Nutrition Literacy Scale for Elderly Patients with COPD has good reliability and validity, which can be used to assess the nutrition literacy level of patients.