This study aims to develop an empathy measurement tool for Saudi children with attention deficit hyperactivity disorder. A total of 850 children with attention deficit hyperactivity disorder were recruited by random sampling method from school in Makka. The Questionnaire of Cognitive and Affective Empathy (QCAE) was used. Exploratory factor analysis was used to reanalyze the structure of the scale, and selected the Empathy scale to test the structural validity of the revised QCAE scale. The QCAE was revised among Saudi children with attention deficit hyperactivity disorder. After revision, the scale finally retained 17 items, which were divided into three dimensions: perspective taking, online simulation, and emotional response. In general, the scale has a moderate number of items and no reverse scoring items. Various indicators show that the three-factor structure is more suitable for children than the four-factor or five-factor structure of other groups.