Objectives: A growing body of research has identified health literacy as an important factor that influences the outcomes and costs of health care delivery. Several English and Spanish health literacy measurement tools have been developed and widely used. With the lack of an appropriate and reliable assessment tool in Chinese、 our understanding of health literacy and its effects on health and health service utilization in Mandarin Chinese speaking populations has been constrained. The purpose of this study is to describe the development of the Mandarin Health Literacy Scale (MHLS) and to assess its psychometric properties. Methods: We employed several procedures to develop a health literacy measurement tool , including an expert panel, item generation , the Delphi process, readability testing, pilot testing, and field testing. Various different types of analysis, including item response theory analysis, factor analysis, reliability testing and validity testing, were conducted to examine the psychometric qualities of the MHLS. Results: There were 50-items included in the MHLS for the validation study, and 323 subjects completed the questionnaire survey. Results show that the MHLS had good internal reliability (Cronbach'sα = 0.95). [n addition, the results for the convergent and predictive validity were statistically significant. Conclusions: More research is needed to further validate the MHLS using a number of distinct subpopulations of Mandarin Chinese speaking adults and to establish their standard levels of health literacy using the MHLS.