Objective To establish a nursing risk assessment index system(NRAIS) for stroke-associated pneumonia (SAP), and provide reference for the prevention and control of SAP. Methods On the basis of literature analysis and semi-structured interviews, the basic framework of NRAIS for SAP was preliminarily drawn up. Indexes were screened by using Delphi method and analytic hierarchy process, the weight of index was calculated. Results The NRAIS for SAP consisting of 6 first-level indexes and 33 second-level indexes was constructed, positive coefficient of expert of two rounds consultation were 88.89% and 100% respectively, authoritative coefficients was 0.8%. Conclusion The constructed assessment index system can effectively help managers identify high-risk factors and high-risk links of SAP, and provide evaluation basis for effective prevention of clinical nursing risks.