Objective To develop the Autonomy Care Practices Assessment Scale for Caregivers of the disabled elderly at home, and to test its reliability and validity, so as to provide a tool for conducting relevant assessment. Methods The autonomy in Self-Determination Theory (SDT) and the International Classification of Functioning, Disability and Health (ICF) were used as the conceptual framework for scale development. A draft scale was formed after literature review, semi-structured interview and the Delphi technique. Then from July to October 2024, a stratified random sampling method was utilized to select 489 home-based caregivers of disabled elderly from 6 communities in Chongqing to test the reliability and validity of the scale. Results Six common factors were extracted through exploratory factor analysis, the cumulative variance contribution rate was 76.142%.The results of confirmatory factor analysis showed that χ2/df=1.174, GFI=0.830, CFI=0.977, TLI=0.974, IFI=0.978, RMSEA=0.037, SRMR=0.046, indicating a good model fit. The content validity index at item level and scale level was 0.875-1.000 and 0.931. The Cronbach′s α coefficient, split-half reliability and test-retest reliability of the total scale were 0.944, 0.857 and 0.981, respectively. The final Autonomy Care Practices Assessment Scale for Caregivers of the disabled elderly at home consisted of 6 dimensions (nutrition, resting and sleeping, cleanliness and grooming, mobility, safety, and social activities) and 28 items. Conclusion The Autonomy Care Practices Assessment Scale for Caregivers of the disabled elderly at home has good reliability and validity, so it can be used to assess the level of autonomous care practices of home-based caregivers effectively.