Aim: To develop and validate the Participation Questionnaire for Preschoolers (PQP), a new disease-specific participation measurement tool for children with autism spectrum disorder (ASD) Methods: In this cross-sectional study, questionnaires were distributed to caregivers of children through child development facilities and medical institutions. The sample comprised 180 children with ASD and 100 children with developmental disabilities without ASD. Additional participants with ASD were recruited through users of a developmental support website. Following item reduction based on the data from children with ASD, exploratory factor analysis was conducted, and Cronbach's alpha coefficients were calculated. Correlations between PQP scores and age, symptom severity, sensory processing, and family functioning were evaluated to examine the construct validity. PQP scores for children with ASD were then compared with those for children with developmental disabilities. Results: In total, 412 participants completed the questionnaire. Item reduction analysis led to the exclusion of seven items, revealing four factors. The PQP demonstrated high internal consistency and good construct validity, with observation of score differences based on the presence or absence of an ASD diagnosis. Conclusion: The PQP appears to be an effective tool for children with ASD. However, further research is required to assess its longitudinal properties.