ObjectiveTo explore the items affecting the prioritization of clinical questions and to construct an evaluation scale for prioritizing clinical question of traditional Chinese medicine (TCM) guidelines. MethodsLiterature analysis and cognitive interview were used to construct the pool of items for evaluating the prioritization of clinical questions of TCM guidelines, and Delphi methods was used to identify the items to form the evaluation scale. ResultsA total of 47 articles were included in the literature, and the two rounds of Delphi questionnaires had a recovery rate of 72% and 100%, respectively. The mean value of the importance of the items in the first round ranged from 3.78 to 4.78, with a coefficient of variation ranging from 0.09 to 0.30, and the mean value in the second round ranged from 4.06 to 4.72, with a coefficient of variation ranging from 0.09 to 0.29. The evaluation scale for the prioritization of clinical questions of TCM guidelines (first edition) was constructed, which contains 13 entries in 4 dimensions. ConclusionThis study explored the items affecting the prioritization of clinical questions in TCM guidelines and developed a prioritization evaluation scale, which improved the lack of objectivity and interpretability of the current prioritization of clinical questions in TCM guidelines to a certain extent, and strengthened the transparency of the process of selecting clinical issues in TCM guidelines.