Orbital malignant tumours seriously affect the quality of life of patients; however, there is currently no quality-of-life questionnaire for patients with orbital malignant tumours.To develop and evaluate a quality-of-life questionnaire for patients with orbital malignant tumours.A pool of items was generated through a literature search, expert meeting and patient interview. Pre-survey and scale evaluation were performed, the quality-of-life questionnaire for patients with orbital malignant tumours (QLQ-OT) was modified, and the scale was evaluated by measuring the quality of life of 46 patients with orbital tumours.The effective rate of QLQ-OT was 97.4%, the Cronbach's alpha coefficient was >0.6, and the test-retest reliability Intraclass Correlation Coefficient was >0.7, suggesting good internal consistency and test-retest reliability. The Pearson correlation coefficients were >0.8 between individual domain scores; > 0.6 between items and their own domains in the QLQ-OT; and >0.6 between domains and their corresponding domains in Quality of Life Center Questionnaire, thereby indicating good content, convergent and criterion-related validity. Ten principal components (the initial eigenvalues >1) were abstracted from 38 items of the general by factor analysis, accounting for 81.0% of cumulative variance.QLQ-OT has good compliance, reliability, validity and responsiveness and can be used to measure the quality of life of patients with orbital malignant tumours.© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.