Objective: This paper describes the development and ef®cacy of a diet quality index (DQI) for China. Design: The Dietary Guidelines for Chinese Residents motivated the selection of 10 DQI components. These components were weighted and assigned cut-offs and point schemes based on the Chinese Food Guide Pagoda, Chinese andaor international dietary reference values. The ef®cacy of resulting DQI scores was assessed relative to a priori expectations. Subjects: The Chinese DQI was evaluated using cross-sectional 3 day diet record and anthropometric data on 7450 adults from the 1991 China Health and Nutrition Survey. Methods: For each individual, a DQI total score was calculated as the sum of components, and DQI pattern scores calculated to re¯ect the underlying composition of diet quality problems. The DQI scores were compared with component scores, food and nutrient intake, weight status and sociodemographic variables. Results: The total DQI score simultaneously represented all component aspects of diet quality as well as micronutrients not explicitly built into the index. The total DQI score was signi®cantly correlated with food and nutrient intakes, BMI, urban residence and income. The DQI pattern scores correlated with DQI components and weight status as expected. Conclusions: The China DQI captures variation along several components of diet quality, appears sensitive to under-and overnutrition, as well as sociodemographic variables. The China DQI may prove useful for monitoring the nutrition transition and epidemiologic trends in China. Sponsorship: National Institutes of Health (HD 38700 and R01-HD30880) and the Chinese Academy of Preventive Medicine. Descriptors: China; dietary intake; diet quality