BACKGROUND: Knowledge can guide and support behaviors. With accurate knowledge, patients are better equipped to engage in appropriate self-care behaviors and effectively manage hypoglycemia. However, there is currently a lack of reliable and valid assessment scales specifically designed to measure hypoglycemia knowledge, which could serve as valuable clinical evaluation tools for healthcare professionals. AIM: To develop and validate a reliable and valid hypoglycemia management knowledge scale to assess the knowledge of hypoglycemia management in patients with diabetes. METHODS: A cross-sectional study was conducted, recruiting 300 patients with type 2 diabetes who had experienced hypoglycemic events from a medical center and a primary care clinic in southern Taiwan between December 2021 and September 2023. RESULTS: Initially, 25 questions were selected, achieving a content validity index of 0.92. Through exploratory factor analysis and confirmatory factor analysis, the scale was refined into an 8-factor and 3-factor model, with factor loadings ranging from 0.5 to 0.9. The questions were categorized into three factors: blood glucose determination, carbohydrate supplementation, and blood glucose testing. The internal consistency, measured using the Kuder-Richardson 20 (KR-20), was 0.758. CONCLUSIONS: The hypoglycemia management knowledge scale developed in this study demonstrated sufficient validity and reliability, making it a useful tool for quickly assessing patients' knowledge of hypoglycemia management and serving as a reference for hypoglycemia education.